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FOxTROT Trial: Neoadjuvant Chemotherapy for Colon Cancer

By: Kelly M. Hennessey, PhD
Posted: Wednesday, November 6, 2019

Patients with operable, nonobstructed colon cancer appear to have improved perioperative morbidity and experienced a trend toward better disease control at 2 years with 6 weeks of neoadjuvant chemotherapy, according to the results of the randomized, multicenter FOxTROT clinical trial. This study was presented by Dion Morton, MD, of the University of Birmingham, United Kingdom, at the European Society for Medical Oncology Congress 2019 (Abstract 523O) and published in the Annals of Oncology.

In total, 1,052 patients from the United Kingdom, Denmark, and Sweden were randomly assigned 2:1 to pre- and postoperative neoadjuvant chemotherapy or postoperative FOLFOX (fluorouracil, leucovorin, oxaliplatin) chemotherapy (control). Total planned chemotherapy was the same in both arms, but those patients receiving neoadjuvant chemotherapy received the treatment 6 weeks prior to surgery. The primary outcome measured was freedom from recurrent or residual disease within 2 years. Secondary outcomes included safety, histologic stage, completeness of resection, and overall survival.  

Neoadjuvant chemotherapy was reported to be well tolerated. Serious perioperative morbidity was lower and there were fewer postoperative complications. Additionally, histologic regression was seen in 59% of patients. There was improvement in the 2-year failure rate, although it was not statistically significant. “Neoadjuvant chemotherapy for colon cancer improves surgical outcomes and can now be considered as a treatment option; longer follow-up and further trials are required to confirm the long-term benefits, refine its use, and optimize case selection,” concluded the authors, in their abstract presented at the 2019 American Society of Clinical Oncology Annual Meeting.

Disclosure: The study authors reported no conflicts of interest.



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