EXPERT-C

Patients with high-risk rectal cancer are commonly treated with chemotherapy and radiotherapy before treatment in an attempt to improve their chance of a long-term cure. The EXPERT-C trial aimed to assess whether adding a new drug called cetuximab to standard chemotherapy would increase the number of patients who had a “complete response” to treatment (where the tumour completely disappears) and whether this improved their survival.

The researchers randomly assigned 90 patients to either standard chemoradiotherapy or chemoradiotherapy with cetuximab. The patients went on to have surgery after this initial treatment. Although there was no statistical difference in the number of patients who had a complete response, the group receiving cetuximab had significantly improved overall survival compared to the chemoradiotherapy alone group.

The abstract of the published paper can be found here Multicenter randomized phase II clinical trial comparing neoadjuvant oxaliplatin, capecitabine, and preoperative radiotherapy with or without cetuximab followed by total mesorectal excision in patients with high-risk rectal cancer (EXPERT-C) - PubMed

Pelican initially supported the trial with a grant of £200,000 but the investigators were later awarded a large grant from Cancer Research UK which allowed them to continue further research into particular molecular markers which could predict whether patients would respond to cetuximab (including KRAS/BRAS and TP53 status). This research added to the evidence base about which patients should receive cetuximab before surgery.