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Cancer, RectumPhase 3STELLARNCT02533271

Optimization of Preoperative Treatment in Locally Advanced Rectal Cancer

A Phase 3 study testing Short-course radiotherapy with neoadjuvant chemotherapy and Long-term chemoradiotherapy in people with Cancer, Rectum, run by Chinese Academy of Medical Sciences at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The purpose of this study is to compare effectiveness of short-term radiotherapy with neoadjuvant chemotherapy(TNT group) with preoperative long-term chemoradiotherapy(CRT group) in locally advanced rectal cancer. The hypothesis is 3-year disease-free survival in TNT group was non-inferior to that in CRT group. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Cancer, Rectum
What is being tested?
Short-course radiotherapy with neoadjuvant chemotherapy and Long-term chemoradiotherapy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
600 participants
Where
1 siteChina
Study dates
Aug 2015to Aug 2025
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Biopsy proven rectal adenocarcinoma;
  • Distance between tumour and anal verge≤ 10cm;
  • Locally advanced tumour;(AJCC Cancer Staging:T3, T4 or N+)
  • Cancer Staging must be based on pelvic MRI;
  • Eastern Cooperative Oncology Group(ECOG) performance score ≤ 1;
  • Written informed consent;
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  • Mentally and physically fit for chemotherapy;
  • Adequate blood counts: White blood cell count ≥3.5 x 109/L Haemoglobin levels ≥100g/L Platelet count ≥100 x 109/L Creatinine levels ≤1.0× upper normal limit(UNL) Urea nitrogen levels ≤1.0× upper normal limit(UNL) Alanine aminotransferase(ALT) ≤1.5× upper normal limit(UNL) Aspartate aminotransferase(AST) ≤1.5× upper normal limit(UNL) Alkaline phosphatase(ALP) ≤1.5× upper normal limit(UNL) Total bilirubin(TBIL) ≤1.5× upper normal limit(UNL)
  • No excision of tumor, chemotherapy or other anti-tumor treatment after the diagnosis.

Who cannot join

  • Distant metastases;
  • Recurrent rectal cancer;
  • Active Crohn's disease or ulcerative colitis;
  • Concomitant malignancies;(except basocellular carcinoma or in-situ cervical carcinoma)
  • Allergic to Fluorouracil or Platinum drugs;
  • Contraindications to MRI for any reason;
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  • Concurrent uncontrolled medical condition;
  • Pregnancy or breast feeding;
  • Known malabsorption syndromes or lack of physical integrity of upper gastrointestinal tract;
  • Symptoms or history of peripheral neuropathy

Trial locations and contacts

1 site in 1 country.

China1 site, 1 recruiting
  • Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College

    Beijing, Beijing Municipality

    Yang Tang, +86-15011304945, tangyuan82@126.com

    Jing Jin, +86-13601365130, jingjin1025@163.com

    Recruiting

Other trials in China

About this study

Official title: Phase III Study of Short-term Radiotherapy Plus Neoadjuvant Chemotherapy Versus Preoperative Long-term Chemoradiotherapy in Locally Advanced Rectal Cancer

The purpose of this study is to compare effectiveness of short-term radiotherapy with neoadjuvant chemotherapy(TNT group) with preoperative long-term chemoradiotherapy(CRT group) in locally advanced rectal cancer. The hypothesis is 3-year disease-free survival in TNT group was non-inferior to that in CRT group.

Read the detailed description

The study is a prospective phase III randomized multicenter trial. The purpose of this study is to compare short-term radiotherapy with neoadjuvant chemotherapy(TNT group) with preoperative long-term chemoradiotherapy(CRT group) for middle-lower locally advanced rectal cancer. The primary endpoint is 3-year disease-free survival,defined as the interval from randomization to the first occurrence of local-regional failure, distant metastasis, second primary tumor or death from any cause. The primary hypothesis was that DFS in the TNT group would be non-inferior to that in the CRT group. After preoperative radiotherapy and surgery, the DFS rate of LARC fluctuated from 50% to 65%. Assuming a 3-year DFS rate in CRT group is 65%, we consider the 3-year DFS rate in the TNT group is not lower than 54% (e.g., a margin of 11% or equivalently, hazard ratio (HR) < 1.43). Guarding against a 5% ineligibility or drop-out rate, the accrual target was 600 patients, with the final analysis to occur after at least 194 DFS events to provide at least 80% power at 1-sided type 1 error of 0.05. The choices of type 1 error and power were made to provide an appropriate comprise between feasibility, timeliness and statistical rigor of evidence generation.

This study seeks to compare outcomes between two groups with respect to rates of overall survival(OS), distance metastasis free survival (DMFS), and locoregional recurrence free survival (LRRFS).In addition, acute and late toxicity profile, completion of preoperative treatment, the proportion of patients with radical resection (R0), surgical complication profile, the rate of pathological complete response (pCR), and quality of life (QoL) are also secondary endpoints.

The STELLAR-trial has been designed by National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, and the hypothesis is 3-year disease-free survival in TNT group was non-inferior to that in CRT group.

Conditions
Cancer, Rectum
Being tested
Short-course radiotherapy with neoadjuvant chemotherapy, Long-term chemoradiotherapy
Keywords
rectal cancer, short-term radiotherapy, neoadjuvant chemotherapy, total mesorectal excision
Medical subject headings
Rectal Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Short-course radiotherapy with neoadjuvant chemotherapyRadiation

    Short-course radiotherapy with 4 cycles of neoadjuvant chemotherapy

  • Long-term chemoradiotherapyRadiation

    Standard chemoradiotherapy

Study groups in NCT02533271
Study groupRoleWhat they receive
TNT groupExperimentalThe intervention of TNT group is Short-course radiotherapy with neoadjuvant chemotherapy, which consists of a short-course radiotherapy (SCRT, 5 Gy x 5 alone), then after 7-10 days of radiotherapy completed, patients will receive neoadjuvant chemotherapy, given in 3 week cycle of capecitabine 1000 mg/m2 twice daily, day 1-14 combined with oxaliplatin 130 mg/m2 once. In total, 4 cycles of neoadjuvant chemotherapy are prescribed preoperatively, then followed by a total mesorectal excision(TME) and postoperative adjuvant chemotherapy. If patients are eligible for postoperative chemotherapy this should consist of at least 2 cycles, which are the same as neoadjuvant chemotherapy.
Receives: Radiation: Short-course radiotherapy with neoadjuvant chemotherapy
CRT groupOtherThe intervention of CRT group is long-term chemoradiotherapy(CRT), which consists of a long-term chemoradiation (2 Gy x 25 with capecitabine) preoperatively, followed by a total mesorectal excision(TME) and then postoperative adjuvant chemotherapy. The radiotherapy is given in combination with capecitabine in a dose of 825 mg/m2 twice daily on days when radiotherapy, excluding weekends. If patients are eligible for postoperative chemotherapy this should consist of at least 6 cycles of capecitabine 1000 mg/m2 twice daily, day 1-14 combined with oxaliplatin 130 mg/m2 once every 3 weeks.
Receives: Radiation: Long-term chemoradiotherapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Disease-free survival rate

    Measured: three year

Secondary outcomes (8)
  1. Overall survival rate

    Measured: three year

  2. Distance metastasis free survival rate

    Measured: three year

  3. Locoregional recurrence free survival rate

    Measured: three year

  4. Incidence of surgical complications

    Surgical complications are defined as those occurring within 30 days after surgery, such as re-operation, anastomotic fistula, bleeding, infection and death related to the operation, etc.

    Measured: one month

  5. Incidence of acute toxicities during radiation or chemotherapy

    Number of participants with abnormal laboratory values and/or adverse events that are related to radiation or chemotherapy as assessed by Common Toxicity Criteria for Adverse Effects(CTCAE) v4.0.

    Measured: three months

  6. Radical resection (R0)

    R0 resection rate is R0 resection probability of radical surgery in patients with locally advanced rectal cancer after neoadjuvant therapy

    Measured: one year

  7. The rate of pathological complete response (pCR)

    PCR rate is pathological ypT0N0 probability of radical surgery in patients with locally advanced rectal cancer after neoadjuvant therapy

    Measured: one year

  8. Quality of life (QoL)

    Quality of life will be assessed using the EORTC QLQ C30, EORTC QLQ Cr29 and Wexner score.

    Measured: up to three years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Aug 2015 (estimated)
  2. Study startAug 2015
  3. Primary completionAug 2023 (estimated)
  4. Study completionAug 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
600 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02533271
Sponsor's protocol ID
XT2015-03
Other IDs
CH-GI-090
Acronym
STELLAR
Status last verified
Jul 2021
First submitted
21 Aug 2015
Last updated
16 Jul 2021
Results posted
No
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • Tang Y, Zhou HT, Xu TZ, Li N, Jiang LM, Jiang J, Lu NN, Li S, Chen SL, Ma HY, Cai Y, Li YH, Zhu Y, He MY, Wang X, Liu K, Zhang HY, Wang J, Zhao T, Li GF, Yang JL, Zhang K, Wang WL, Xiao WW, Chi Y, Yang L, Zhou AP, Zou SM, Fang H, Wang SL, Zhang HZ, Wang XS, Wei LC, Liu SX, Gao YH, Li YX, Hu C, Jin J. Five-Year Outcomes of Short-Term Radiotherapy Plus Chemotherapy Versus Long-Term Chemoradiotherapy for Locally Advanced Rectal Cancer: Updated Results of the STELLAR Trial. J Clin Oncol. 2026 Sep;44(25):2371-2378. doi: 10.1200/JCO-25-02387. Epub 2026 Jul 27.

    PubMed 42507974
  • Wang N, Xu T, Li H, Shuai J, Ma H, Fang H, Song Y, Chen B, Lu N, Jing H, Liu X, Qi S, Zhang W, Liu Y, Li Y, Wang S, Dou L, Jin J, Tang Y. Diabetes and Performance Status Predict Severe, Persistent Radiation Proctitis: Long-Term Endoscopic Findings From STELLAR Trial. Int J Radiat Oncol Biol Phys. 2026 May 15:S0360-3016(26)00722-4. doi: 10.1016/j.ijrobp.2026.05.004. Online ahead of print.

    PubMed 42142768
  • Xu T, Ma H, Zhang W, Yang Y, Xiao W, Li N, Li H, Gao Y, Liu S, Wei L, Jiang L, Shi J, Shuai J, Cai Y, Li Y, Cheng G, Luo W, Wang X, Liu K, Wang J, Lu N, Fang H, Liu Y, Song Y, Zhang W, Wang S, Li Y, Zhou A, Zhou H, Chi Y, Tang Y, Jin J. Minimum 18-week chemotherapy improves survival in locally advanced rectal cancer after neoadjuvant radiotherapy: a post hoc analysis of the STELLAR trial. BMC Med. 2026 Feb 25;24(1):190. doi: 10.1186/s12916-026-04731-0.

    PubMed 41742206
  • Ma H, Li H, Xu T, Gao Y, Liu S, Wang W, Wei L, Wang X, Jiang L, Chi Y, Shi J, Shuai J, Zou S, Cai Y, Zhu Y, Cheng G, Zhang H, Wang X, Zhu S, Wang J, Li G, Yang J, Zhang K, Lu N, Fang H, Wang S, Li Y, Zhou H, Tang Y, Jin J. Multidisciplinary team quality improves the survival outcomes of locally advanced rectal cancer patients: A post hoc analysis of the STELLAR trial. Radiother Oncol. 2024 Nov;200:110524. doi: 10.1016/j.radonc.2024.110524. Epub 2024 Sep 5.

    PubMed 39243864
  • Jin J, Tang Y, Hu C, Jiang LM, Jiang J, Li N, Liu WY, Chen SL, Li S, Lu NN, Cai Y, Li YH, Zhu Y, Cheng GH, Zhang HY, Wang X, Zhu SY, Wang J, Li GF, Yang JL, Zhang K, Chi Y, Yang L, Zhou HT, Zhou AP, Zou SM, Fang H, Wang SL, Zhang HZ, Wang XS, Wei LC, Wang WL, Liu SX, Gao YH, Li YX. Multicenter, Randomized, Phase III Trial of Short-Term Radiotherapy Plus Chemotherapy Versus Long-Term Chemoradiotherapy in Locally Advanced Rectal Cancer (STELLAR). J Clin Oncol. 2022 May 20;40(15):1681-1692. doi: 10.1200/JCO.21.01667. Epub 2022 Mar 9.

    PubMed 35263150

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Short-course radiotherapy with neoadjuvant chemotherapy and Long-term chemoradiotherapy in people with Cancer, Rectum, run by Chinese Academy of Medical Sciences at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 16 Jul 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Yuan Tang (+86-15011304945, tangyuan82@126.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Disease-free survival rate (time frame: three year). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02533271, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Jul 2021.

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