Comparing two chemotherapy approaches for high-risk rectal cancer treatment

Induction Versus Consolidation Chemotherapy in Total Neoadjuvant Therapy of Localy Advanced Rectal Cancer With High Risk of Recurrence (ICONA Study)

Phase 2 Interventional Institute of Oncology Ljubljana · NCT05054959

This study tests which chemotherapy method works better for people with high-risk rectal cancer by comparing a standard approach with a new one to see which helps them respond better to treatment.

Quick facts

PhasePhase 2
Study typeInterventional
Enrollment62 (estimated)
Ages18 Years and up
SexAll
SponsorInstitute of Oncology Ljubljana Academic / other
Drugs / interventionschemotherapy
Locations1 site (Ljubljana)
Trial IDNCT05054959 on ClinicalTrials.gov

What this trial studies

This study aims to determine the most effective sequence of chemotherapy modalities in the total neoadjuvant treatment of locally advanced rectal cancer (LARC) with a high risk of recurrence. It will compare the standard approach of induction chemotherapy followed by consolidation chemotherapy against a regimen that utilizes only consolidation chemotherapy. The study is designed to identify which method leads to better outcomes, particularly in achieving a pathological complete response (pCR). Participants will be monitored throughout the treatment process to assess the effectiveness of the therapies.

Who should consider this trial

Good fit: Ideal candidates for this study are individuals with histologically proven rectal adenocarcinoma and specific high-risk factors for recurrence.

Not a fit: Patients with distant metastases, previous pelvic irradiation, or certain contraindications may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to improved treatment protocols for patients with high-risk rectal cancer, potentially reducing recurrence rates.

How similar studies have performed: Previous studies have shown promising results with consolidation chemotherapy in similar contexts, indicating potential for success in this approach.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:- histologically proven rectal adenocarcinoma

* no distant metastases on CT scan (M0 disease)
* at least one high risk factor for disease recurrence identified on MR imaging:

  * T4 tumor (cT4)
  * N2 disease (cN2)
  * extramural venous invasion (cEMVI+)
  * positive lateral lymph nodes
  * distance of tumor to mesorectal fascia or positive lymph nodes is 1 mm or less (cMRF+)
* capacity for informed consent
* willingness to attend regular check-ups during and after treatment

Exclusion Criteria:history of previous irradiation in the pelvic area

* absolute contraindications for MR imaging
* distant metastases cannot be reliably excluded
* synchronous cancer
* chronic inflammatory bowel disease

Where this trial is running

Ljubljana

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Locally Advanced Rectal Cancerrectal cancertotal neoadjuvant therapyinduction chemotherapyconsolidation chemotherapy
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.