A randomized phase III rectal cancer trial out of China just reported some great results for Locally Advanced Rectal Cancer (and confirms our modern TNT practice). TNTCRT randomized 458 patients with high-risk LARC to conventional long-course CRT → surgery → adjuvant chemotherapy versus CAPOX before, during, and after long-course radiation. Yep. Doublet chemo, all the way through. 3-year DFS: 74.8% vs 66.0% HR 0.67 MFS: 77.7% vs 67.6% HR 0.66 pCR: 26.4% vs 9.8% Big numbers, much win. But the criticism is the comparator. The control arm is not how we treat high-risk rectal cancer in the US. We already know TNT is better than CRT → surgery → adjuvant chemotherapy based on OPRA's modern benchmark. With CRT followed by consolidation FOLFOX/CAPOX, 3-year DFS was 76%, essentially the same as the 74.8% seen here. But OPRA also comes with the added benefit of TME-free survival of 54%. I think what is still impressive is the scale and speed of this trial. The Chinese trial infrastructure is fully operational and anyone in drug development should take note. @TheGutOncLab @OncoAlert

🚨 MSK’s @AndreaCercek presented full interim results from the AZUR-1 trial at #ESMO26# in Madrid. The trial tested Jemperli (dostarlimab) in people with stage 2 and 3 rectal cancer whose tumors are mismatch repair-deficient (MMRd) or microsatellite instability-high (MSI-H). Among patients for whom the approach worked, no cancer has returned during follow-up. The approach, developed at MSK by Dr. Cercek and Dr. Luis Diaz Jr. (@ldiaz1971), allows some patients to avoid treatments that can have life-altering consequences, including infertility and bowel and bladder dysfunction. The @FDA approved the approach in October 2026, calling it "groundbreaking. “It’s incredibly rewarding,” says Dr. Cercek, “to get these happy tears and happy emails from the patients who finish treatment and realize, ‘Oh my God, I get to keep all my normal body functions that I feared I might lose to radiation or surgery.’” Learn more:

Tomorrow at #ESMO26#: MSK gastrointestinal medical oncologist @AndreaCercek will present the first results from the global AZUR1 trial of dostarlimab monotherapy in patients with dMMR/MSI-H locally advanced rectal cancer. 🗓️ Sunday, October 25 | 11:00 a.m. CET