FOWARC

Regimen

Experimental
Three arms: (1) neoadjuvant mFOLFOX6 × 4 cycles alone → surgery; (2) neoadjuvant mFOLFOX6 + fluorouracil-based CRT → surgery
Control
Standard fluorouracil + CRT → surgery

Population

Locally advanced rectal cancer cT3–T4 or N+ (N=495), China multicenter; evaluating chemotherapy ± radiation neoadjuvant approaches.

Key finding

3-year DFS: mFOLFOX6 alone 73.4% vs mFOLFOX6+CRT 75.6% vs 5-FU+CRT 73.7% (P=0.74, no significant difference); pCR rates: mFOLFOX6 alone 6.1% vs mFOLFOX6+CRT 27.5% vs 5-FU+CRT 15.4%. Chemotherapy alone achieves similar DFS as CRT-based approaches in LARC.

Source: PMID 31557064

Timeline

    Guideline citations

    • NCCN Rectal (p.108)