Dr. Van Loon on the PROSPECT Trial

Katherine Van Loon, MD, gastrointestinal cancer specialist, University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, discusses the design of multicenter PROSPECT trial.

PROSPECT will inform our management of the disease, states Van Loon. The trial is randomizing patients to the standard of care, chemoradiation followed by surgery and adjuvant therapy, to neoadjuvant leucovorin calcium, fluorouracil, and oxaliplatin (FOLXFOX) for 6 cycles. The patients who undergo neoadjuvant FOLFOX then undergo restaging. Those who have a greater than 20% response rate proceed directly to surgery, potentially sparing them from pelvic radiation therapy.

Physicians eagerly anticipate the results of this trial as it will attempt to answer whether or not patients who respond well to neoadjuvant chemotherapy can be spared the toxicity of pelvic radiation therapy, and whether or not upfront chemotherapy can reduce the occurrence of distant metastatic disease down the road.