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ASCO 2026 | Five-year survival outcomes with SCRT plus chemo-immunotherapy in MSS LARC
Ali Shamseddine, MD, Basile Cancer Institute at the American University of Beirut, Beirut, Lebanon, discusses the Averectal trial (NCT03503630) evaluating short-course radiation therapy followed by mFOLFOX-6 plus avelumab in microsatellite-stable locally advanced rectal cancer (MSS LARC). Adding avelumab to total neoadjuvant therapy significantly improved pathologic complete response rates versus historical controls. At five years, overall survival and disease-free survival remained favorable, with a low local recurrence rate observed across the cohort. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
The primary endpoint of the trial was a complete pathologic response rate, and the complete pathologic response rate was 37.5% compared to the conventional complete response rate, which is 16%, with a significant p-value. Based on that, we notice also in this trial specifically, we measure what they call an immunoscore. The immunoscore is the mean value of four digits, which are the CD3 and CD8 in the core and the center of the tumor, and the mean value of the four digits in the immunoscore...
The primary endpoint of the trial was a complete pathologic response rate, and the complete pathologic response rate was 37.5% compared to the conventional complete response rate, which is 16%, with a significant p-value. Based on that, we notice also in this trial specifically, we measure what they call an immunoscore. The immunoscore is the mean value of four digits, which are the CD3 and CD8 in the core and the center of the tumor, and the mean value of the four digits in the immunoscore. Previously, immunoscore was used as a prognostic, but no trial used immunoscore as a therapeutic or prediction of outcome. And in our trial, we proved that those with a high immune score, those with a complete pathologic complete response, harbor a high immune score compared to a non-complete response rate, which is in the range of a mean value of 68 versus 52 with a significant p-value. Going to the five-year outcome and after a median follow-up of 72.1 months, we have the overall survival as a median that did not reach and disease-free survival, but as a mean it reached about 85 months as overall survival, 85 months, with disease-free survival in the range of 78%.
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