XELAC RT (Università Cattolica del Sacro Cuore)

XELAC RT is a neoadjuvant chemoradiotherapy regimen developed for the treatment of locally advanced, resectable cT3 rectal cancer. It was evaluated in the INTERACT Phase III trial (NCT01653301) sponsored by the Catholic University of the Sacred Heart. The regimen consists of the oral fluoropyrimidine prodrug capecitabine (administered at 1650 mg/m²/day) concurrently with an intensified radiotherapy schedule. This schedule includes 45 Gy delivered at 1.8 Gy/day to the pelvis, supplemented by a concomitant boost of 10 Gy (1 Gy twice weekly) to the bulky tumor site, reaching a total dose of 55 Gy. The name 'XELAC' is derived from 'XELoda' (capecitabine) and 'AC' (accelerated/concomitant boost radiotherapy). Capecitabine acts as a small molecule antimetabolite that is converted to 5-fluorouracil, which inhibits thymidylate synthase and disrupts DNA synthesis, while the radiotherapy induces direct DNA damage in cancer cells.

Other names

capecitabine plus intensified radiotherapycapecitabine plus accelerated radiotherapycapecitabine plus concomitant boost radiotherapy