Landmark trial offers new treatment option for early-stage rectal cancer

Cancer patients have avoided major surgery and a permanent colostomy bag after taking part in a major international trial co-led by the Universities of Leeds and Birmingham.
The patients, who all had early-stage rectal cancer, were treated with combinations of chemotherapy and radiotherapy to see if they could safely avoid major surgery, which is the current standard of care.
Published in Lancet Oncology and funded by Cancer Research UK, the initial results suggest that organ-preserving treatment may be a realistic option for many people with early rectal cancer – and has fewer side effects than major surgery.
The trial, named STAR-TREC, was co-led by Professor David Sebag-Montefiore in Leeds and Professor Simon Bach at UCL, and co-ordinated by the University of Birmingham. Patients were recruited to trial centres in the UK, the Netherlands, Sweden, Denmark and Belgium.
Professor Sebag-Montefiore said: ‘These exciting results are an example of how a smarter, kinder radiotherapy treatment may allow patients to avoid the need for major surgery. It is gratifying that patients experienced a relatively low level of severe short-term side effects as a result of the smaller, more targeted radiotherapy approach that we specifically developed for STAR-TREC.’
Professor Bach said: ‘For decades we’ve asked patients to accept the loss of their rectum – and often a permanent stoma – as the price of curing their cancer. What these results suggest is that for many people, this price no longer has to be paid. Four in five patients treated with chemoradiotherapy kept their rectum. The next step is to confirm these results hold over the longer term, and then to make sure the approach is available to every patient who could benefit.’
Michelle Mitchell, Cancer Research UK’s chief executive, said: “This breakthrough could be life-changing for thousands of people. Thanks to bowel screening, more rectal cancers are being spotted at an earlier stage, where people are more likely to survive the disease, but that hasn't made treatment any easier – many patients still have to cope with extremely difficult and often life-altering side effects. Remarkably, that could finally be about to change with this new treatment option, which has the potential to transform the lives of people affected by this cancer and their families.’