Folfoxiri Plus Bevacizumab Followed by Chemoradiotherapy Plus Bevacizumab in Patients With Resectable Rectal Cancer

Inclusion Criteria: * Histologically proven diagnosis of rectal adenocarcinoma. Diagnosis obtained by a biopsy technique which leaves the major portion of the tumor intact. * Locally advanced, resectable disease defined by the presence of at least one of the following features: tumour extending to within 1 mm of or beyond the mesorectal fascia (ie, circumferential radial margin threatened or involved); lower third (≤ 6 cm from the anal verge) cT3 tumours; tumour extending 5 mm or more into perirectal fat; T4 tumour (ie, invading surrounding structures or peritoneum); clinical stage III disease (T1-4, N1-2), with the definition of a clinically positive lymph node being any node ≥ 1.0 cm; * Distal border of the tumor must be located \< 12 cm from the anal verge. * No evidence of metastatic disease by CT scan of the chest and abdomen and total body PET-CT scan. * Tumor must be amenable to curative resection (curative resection can include pelvic exenteration). * No history of invasive rectal malignancy, regardless of disease-free interval. * No other rectal cancers (i.e., sarcoma, lymphoma, carcinoid, squamous cell carcinoma, or cloacogenic carcinoma) or synchronous colon cancer. * No clear indication of involvement of the pelvic side walls by imaging. * Age between 18 and 75 years. * ECOG Performance status \< 2 if age \< 70 years and = 0 if age 71-75 years. * Life expectancy of at least 5 years (excluding diagnosis of cancer). * Hematopoietic: absolute neutrophil count ≥ 1,00…