Evaluating a Nonessential Amino Acid Restriction (NEAAR) Medical Food With Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer (LARC)

Inclusion Criteria:

• Histologically confirmed diagnosis of adenocarcinoma of the rectum

• Clinical stage II (cT3-4, N-) or Stage III (cT any, N+) based on MRI

• Eligible for total mesorectal excision

• No evidence of distant metastasis

• No prior pelvic radiation therapy

• No prior chemotherapy

• Age ≥18 years

Exclusion Criteria:

• Patients unable to undergo MRI

• Other anticancer or experimental therapy

• Body mass index (BMI) <18.5 kg/m2 or >40 kg/m2

• Serious or refractive cachexia or anorexia

• Insulin-dependent diabetes Taking or needs to take any protein or amino acidcontaining nutritional supplements (e.g., Ensure®) Patients with a condition wherehigh-fat or fatty food is contraindicated History of confirmed food allergy Activewound or skin graft that would require a significant increase in proteinrequirements for skin integrity and healing