Chemotherapy first approach reduces risk of colon cancer return

Chemotherapy before surgery reduces the risk of colon cancer returning in two years by 28%, according to a new study.

The FOxTROT trial, led by scientists at the University of Birmingham and the University of Leeds, involved 1,053 colon cancer patients from 85 hospitals in the UK, Denmark and Sweden.

The researchers say their findings, published last night in the Journal of Clinical Oncology, could be easily adopted by health systems across the world and would benefit thousands of patients.

For the Cancer Research UK-funded trial, colon cancer patients were divided into two groups. The first group received six weeks of chemotherapy, followed by surgery, then 18 weeks of chemotherapy. The second group had standard treatment for colon cancer, which was surgery followed by 24 weeks of chemotherapy.

Patients in the first group were significantly less likely to see their cancer return, compared with those in the second group who had standard care.

Dr Laura Magill, associate professor at the Birmingham Clinical Trials Unit at the University of Birmingham, said: “Up to one in three colon cancer patients can see their cancer come back after surgery. That figure is far too high and we need new treatment strategies to stop colon cancer coming back.

“The standard approach has been to give chemotherapy after surgery to eradicate any cancer cells that might have spread before surgery. But our research shows that giving some of that chemotherapy before surgery increases the chances that all cancer cells will be killed.

“A growing body of evidence is showing the value of pre-operative chemotherapy in several other cancers, and we believe that our results could transform how we approach colon cancer in the clinic.”

Professor Matthew Seymour, professor of gastrointestinal cancer research at the University of Leeds, added: “Timing is everything when it comes to treating colon cancer. The simple act of bringing forward chemotherapy, giving it before instead of after surgery, delivers some remarkable results.

“Delivering chemotherapy before surgery could prevent recurrences of cancer without the need for expensive new drugs or technologies. It was especially encouraging to find that patients who had chemotherapy before their surgery suffered fewer surgical complications.

“Scaling up this treatment worldwide, including in low and middle income countries, could transform cancer care and save many thousands of lives.”

Two further clinical trials, FOXTROT-2 and FOXTROT-3, are now under way to investigate if older patients also benefit from chemotherapy before surgery and if adding in more chemotherapy drugs before surgery further reduces the chances of cancer coming back.

Professor Dion Morton, professor of surgery at the University of Birmingham, said: “In many parts of the world cancer treatments can be prohibitively expensive. We wanted to go in the opposite direction, testing a treatment that could be used on the widest possible group of patients.”

Preoperative chemotherapy for operable colon cancer: mature results of an international randomised controlled trial. Journal of Clinical Oncology 19 January 2023

, , , ,

Leave a Reply

Your email address will not be published. Required fields are marked *



Monthly Posts

Our Clients

Practice Index