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On the Forefront of Offering Rectal Cancer Clinical Trials

May 10, 2023 by Kate Strotmeyer

Christopher Anker, M.D.

UVM cancer center is advancing the standard of care.

Starting in 2015, rectal cancer patients treated at the University of Vermont Cancer Center (UVMCC) had access to a groundbreaking clinical trial allowing them to avoid the typically standard surgery if their tumor was found to go away completely after a combination chemotherapy and radiation.

Led locally by colorectal surgeon Peter Cataldo, M.D., study results published this past year demonstrated that over 50% of patients were able to avoid surgery removing their rectum if they received 6 weeks of radiation and chemotherapy plus additional chemotherapy. Because of the dramatic improvement in quality of life for these patients, this approach is the new standard of care at UVMCC. 

While avoiding surgery is one of the most significant advances in rectal cancer in decades, six weeks of daily radiation is still a significant burden on patients and their families. 

Now, research is swinging the pendulum further towards patient quality of life. UVMCC is one of four clinical sites investigating a course of treatment condensing the typical six-week therapy down to one week. One week of radiation had been found to provide equivalent cancer control and quality of life outcomes at Washington University in St. Louis. Researchers hypothesize that in this larger cohort over half of patients will have their cancer completely go away following completion of therapy while maintaining a good quality of life, similar to what is seen with six weeks of radiation. 

The study, called Non-Operative Management and Early Response Assessment in Rectal Cancer (NOM-ERA), was created by Dr. Hyun Kim at Washington University. Local principal investigator Dr. Anker was instrumental in bringing the patient-focused study to UVMCC and in helping with the final trial design. Additional supporting UVMCC members include radiation oncologist Dr. Nat Lester-Coll, colorectal surgeons Drs. Peter Cataldo, Jesse Moore, Krista Evans, and Jeremy Dressler, and medical oncologists Drs. Steven Ades, Randall Holcombe, Molly Barry, Marc Greenblatt, and Sarah Gillett. 

Dr. Anker has established a national reputation for his expertise in treating rectal cancer with a non-operative approach. Outside of Washington University, UVMCC has had the highest number of patients enroll on the trial. While every patient enrolled in the study will have access to the shortened one week of therapy, if the results prove promising the next step will be a major randomized national trial comparing the two approaches. 

Patrick Austin, one of the participants on the study whose tumor resolved completely following radiation and chemo, said of the trial: “I would participate in this course of treatment again without hesitation. The time commitment was easy at one week only; side effects were minimal as they did not build upon each other as treatment proceeded.”

Related: An Alternative to Surgery and a Colostamy Bag? An innovative treatment led to better quality of life for this 46-year-old with rectal cancer. 

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