A Study of Radiotherapy in Rectal Cancer Using Oxaliplatin, Capecitabine With or Without Cetuximab

Inclusion Criteria:

1. All patients must have histologically or cytologically confirmed T3/4 and/or node positive adenocarcinoma of the rectum with the inferior border within 12 cm from the anal verge without evidence of distant metastases, as evaluated by computed tomography, ultrasonography, MRI or clinically.
2. Patients must have normal organ and marrow function as defined below:

   leukocytes \>3,000/mcL absolute neutrophil count \>1,500/mcL platelets \>100,000/mcL total bilirubin within normal institutional limits AST(SGOT)/ALT(SGPT) greater than 2.5 X institutional upper limit of normal creatinine within normal institutional limits
3. Age \>21 years
4. Patients must have ECOG performance status of 0-2.
5. Patients must be 18 years old or greater.
6. The tumor must be considered by the surgeon to be amenable to curative resection.
7. Ability to understand and the willingness to sign a written informed consent document.
8. Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.

Exclusion Criteria:

1. Patients who have had prior chemotherapy or radiotherapy.
2. Patients may not be receiving any other investigational agents.
3. Patients with stage I or IV cancer of the rectum.
4. History of allergic reactions attributed to compounds of similar chemical or biologic composition to cetuximab, oxaliplatin or capecitabine.
5. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
6. Inability to take oral medications.
7. Pregnant women are excluded from this study because agents use in the study may cause fetal harm.
8. HIV-positive patients on combination antiretroviral therapy are ineligible because of the potential for pharmacokinetic interactions with docetaxel. In addition, these patients are at increased risk of lethal infections when treated with marrow-suppressive therapy.
9. History of other malignancies within 5 years, except non-melanoma skin cancer, in situ carcinoma of the cervix or ductal carcinoma of the breast. Previous invasive cancer permitted if disease-free at least 5 years.