{"entity":{"id":"rapido","kind":"trial","name":"RAPIDO","aka":[],"tldr":"RAPIDO showed that giving one week of radiotherapy and then all the chemotherapy before surgery cuts distant spread and doubles complete responses in high-risk rectal cancer, establishing total neoadjuvant therapy.","summary":"RAPIDO randomised 920 patients with high-risk rectal cancer on MRI to short-course radiotherapy (25 Gy in five fractions) followed by six cycles of CAPOX or nine of FOLFOX then surgery, or to standard capecitabine chemoradiation, surgery and optional adjuvant chemotherapy. Disease-related treatment failure at three years was 23.7 percent with the experimental approach versus 30.4 percent, driven by fewer distant metastases, and pathological complete response doubled to 28 percent (Bahadoer and colleagues, Lancet Oncology 2020). Later follow-up reported more local regrowth in the experimental arm, tempering enthusiasm for the shortest radiotherapy.","status":"positive","asOf":"2026-09-17","links":[{"label":"ClinicalTrials.gov NCT01558921","url":"https://clinicaltrials.gov/study/NCT01558921"},{"label":"Lancet Oncology 2020","url":"https://doi.org/10.1016/S1470-2045(20)30555-6"}],"tags":["radiation-wave4"],"related":[],"cancers":["colorectal"],"sections":[],"technologies":["hypofractionated-radiotherapy","imrt-igrt"],"targets":[],"drugs":["capecitabine","oxaliplatin"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"notes":[],"nct":"NCT01558921","phase":"3","setting":"High-risk locally advanced rectal cancer: short-course radiotherapy then chemotherapy before surgery (total neoadjuvant therapy) versus standard chemoradiation, surgery and optional adjuvant chemotherapy","sponsor":"University Medical Centre Groningen","result":"3-year disease-related treatment failure 23.7% vs 30.4%; pathological complete response 28% vs 14%.","yearReported":2020,"enrolled":920,"outcomes":[{"endpoint":"Disease-related treatment failure at 3 years","primary":true,"unit":"%","arms":[{"name":"Total neoadjuvant therapy","n":462,"value":23.7},{"name":"Standard chemoradiation","n":450,"value":30.4}]}]},"route":"/trials/rapido/","neighbours":{"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"}],"technology":[{"id":"hypofractionated-radiotherapy","kind":"technology","name":"Hypofractionated radiotherapy","route":"/technologies/hypofractionated-radiotherapy/"},{"id":"imrt-igrt","kind":"technology","name":"IMRT / IGRT (modern external beam)","route":"/technologies/imrt-igrt/"}],"drug":[{"id":"capecitabine","kind":"drug","name":"Capecitabine","route":"/drugs/capecitabine/"},{"id":"oxaliplatin","kind":"drug","name":"Oxaliplatin","route":"/drugs/oxaliplatin/"}]}}