Systemic Anti-Cancer Therapy Regimen Library
CRC REC Neoadjuvant/Adjuvant - PRODIGE23 Total Neoadjuvant Therapy
Treatment Overview
PRODIGE23 Total Neoadjuvant Therapy (TNT) consists of:
- Neoadjuvant therapy with FOLFIRINOX [oxaliplatin, irinotecan, foliNIc acid and fluorouracil] for 6 cycles, followed by
- Radiotherapy with concurrent capecitabine, followed by
- Total mesorectal excision, then
- Adjuvant chemotherapy for 3 months, with either
- mFOLFOX6 [oxaliplatin, foliNIc acid and fluorouracil] for 6 cycles, or
- capecitabine for 4 cycles.
for 6 cycles, or
for 6 cycles, followed by
Commence with radiation therapy as per protocol.
Followed by total mesorectal excision, then 3 months of adjuvant chemotherapy with either:
for 4 cycles.
Supportive Care Factors
| Factor | Value |
|---|---|
| Diarrhoea risk: | Anti-diarrhoeals are usually prescribed with this treatment |
| Emetogenicity: | Variable |
Regimen details sometimes vary slightly from the published literature after recommendation by expert committee consensus.
* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.
s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.