Loft M, Wong HL, Kosmider S, et al. - A lower rate of pathological complete response (pCR) was offered by capecitabine vs infusional 5-FU in locally advanced rectal cancer (LARC), a difference not explained by assessed patient or tumour features. A likely explanation is poor treatment compliance with oral therapy in the real-world setting. Capecitabine is now the predominantly employed neoadjuvant chemotherapy in LARC.

• Required data were collected from a prospectively maintained colorectal cancer database at three Australian hospitals.

• 657 patients with LARC were analyzed, 498 undergoing infusional 5-FU and 159 receiving capecitabine.

• Post-approval, marked increase in capecitabine use has been noted, now being used in more than 80% of patients.

• In capecitabine-treated patients and in those who received 5-FU, pCR was achieved in 22/159 (13.8%) and in 118/380 (23.7%) patients, respectively.

• Postoperative oxaliplatin was needed in more capecitabine-treated patients.

• Similar 2-year progression-free survival was reported.