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ASCO 2026 | Assessing chemo-IO and RT for MSS rectal cancer in the Averectal trial
Ali Shamseddine, MD, Basile Cancer Institute at the American University of Beirut, Beirut, Lebanon, provides an overview of Averectal trial (NCT03503630) of chemoimmunotherapy (chemo-IO) in MSS rectal cancer. The trial utilizes a total neoadjuvant therapy concept with short course radiation therapy to enhance immunogenic effects and increase the release of neoantigens. The use of short course radiation therapy, in combination with FOLFOX, particularly oxaliplatin, aims to augment local and immunotherapy-related effects, leading to increased cell death. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
The protocol was based on the combination of chemoimmunotherapy in MSS colorectal cancer using total neoadjuvant therapy concept with the use of short course radiation therapy. Why short course? Because the dose intensity per course was higher than the usual long course conventional therapy, and this led to a sort of immunogenic effect that enhanced the release of neoantigens with the use of the checkpoint inhibitor or immunotherapy, this will augment the local and the immunotherapy-related effect...
The protocol was based on the combination of chemoimmunotherapy in MSS colorectal cancer using total neoadjuvant therapy concept with the use of short course radiation therapy. Why short course? Because the dose intensity per course was higher than the usual long course conventional therapy, and this led to a sort of immunogenic effect that enhanced the release of neoantigens with the use of the checkpoint inhibitor or immunotherapy, this will augment the local and the immunotherapy-related effect. Subsequently, the cell deaths from the radiation therapy. And also with the use of the FOLFOX, especially oxaliplatin has an immunogenic effect also. So this is the basic concept of the trial, of the combination.
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