NEWFlashcards for any set of questions, quick-reference tables for breast, lung and prostate, and a month of access for every colleague you refer. See what changed

Lower GI: Total neoadjuvant therapy (PRODIGE-23)

Free question published 19 October 2026

Lower GITotal neoadjuvant therapy (PRODIGE-23)

A 52-year-old man with a cT3 cN1 M0 rectal cancer is counselled about adding induction mFOLFIRINOX before chemoradiotherapy, on the basis of the PRODIGE 23 trial. He asks how much the addition of induction chemotherapy improves the chance of a complete disappearance of tumour in the resected specimen. What did PRODIGE 23 report for the pathological complete response rate in the FOLFIRINOX arm compared with the standard arm?

  1. A28% versus 12%, favouring the FOLFIRINOX arm
  2. B12% versus 28%, favouring the standard arm
  3. C45% versus 28%, favouring the FOLFIRINOX arm
  4. DNo significant difference between the arms
  5. E20% versus 19%, favouring the FOLFIRINOX arm

Why A is correct

PRODIGE 23 reported a pathological complete response rate of 28% (59/212) in the neoadjuvant mFOLFIRINOX group versus 12% (26/215) in the standard preoperative chemoradiotherapy group (P<0.001), roughly doubling the pCR rate. This was accompanied by improved 3-year disease-free survival (76% vs 69%, HR 0.69, P=.034).

And why the others are not

  • BIncorrect. The figures are reversed; the higher rate of 28% was in the FOLFIRINOX arm.
  • CIncorrect. The FOLFIRINOX pCR rate was 28%, not 45%.
  • DIncorrect. The difference was significant at P<0.001.
  • EIncorrect. The pCR rates were 28% versus 12%, a substantial and significant difference, not a marginal one.

Source PRODIGE 23 trial — total neoadjuvant therapy with FOLFIRINOX in locally advanced rectal cancer — Conroy T, Bosset JF, Etienne PL, et al. Neoadjuvant chemotherapy with FOLFIRINOX and preoperative chemoradiotherapy for patients with locally advanced rectal cancer (UNICANCER-PRODIGE 23): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2021.

More free lower gi questions

Sitting in February? Follow the twenty-week plan.

2,500+ cited questions like this one are waiting in the vault.

See plans and pricing