Neoadjuvant FOLFIRINOX and Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer Patients

This study is testing a total neoadjuvant therapy (TNT) approach for locally advanced rectal cancer — giving both chemotherapy (FOLFIRINOX) and chemoradiation before surgery, rather than just one upfront. The goal is to shrink the tumor as much as possible before removal and reduce the chance of it coming back. **You may be eligible if...** - You have been diagnosed with rectal cancer confirmed by biopsy (adenocarcinoma) - Your cancer is locally advanced but has not spread to distant organs - Your cancer is considered resectable (able to be surgically removed) - Your general health is good (ECOG performance 0 or 1) - Your heart, nerve, blood, and liver function are adequate for chemotherapy **You may NOT be eligible if...** - You have had prior radiation to the pelvis or prior chemotherapy - You have heart failure, active coronary disease, or peripheral neuropathy above grade 1 - You have significant other health conditions preventing treatment - You are pregnant without adequate contraception Talk to your doctor to see if this trial is right for you.