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 protein requirementsfor skin integrity and healing