NORPPA-1: A Phase II Trial of Non-Operative Management in Rectal Cancer

The NORPPA-1 study (Nordic ORgan Preservation Pilot Approach) is a nonrandomized single-arm clinical trial evaluating non-operative management for rectal cancer, led by Toni Seppälä at Tampere University Hospital (Tays). All 13 surgical units treating rectal cancer in Finland and Estonia are participating.

Currently, rectal cancer is typically treated with surgery that often impacts patients’ quality of life permanently, frequently requiring permanent colostomy. The study focuses on patients whose tumour disappears completely after pre-treatment with radiation and chemotherapy. These patients are monitored closely instead of proceeding to surgery — every three months for the first two years, then every six months for three years.

Around 20% of patients are expected to experience recurrence and will undergo surgery as per current guidelines. For those who avoid surgery entirely, the benefit to quality of life is significant.

The study also investigates why some tumours respond fully to pre-treatment while others do not, examining tumour composition and the cell types that drive recurrence.

Read the full article at Pirha.fi →

View trial registration at ClinicalTrials.gov (NCT06328361) →