Chemotherapy before surgery cuts the risk of colon cancer relapse

Results of a Cancer Research UK-funded clinical trial reveal that giving colon cancer patients chemotherapy before surgery reduces their risk of the disease returning. The FOxTROT trial showed that giving colon cancer patients chemotherapy before rather than after surgery reduced the chance of cancer returning within two years by 28 per cent. A total of 1035 colon cancer patients from 85 hospitals in the UK, Denmark and Sweden were involved in the study, led by scientists at the University of Birmingham and the University of Leeds.
Associate Professor at the Birmingham Clinical Trials Unit at the University of Birmingham, Dr Laura Magill, said, “Up to 1 in 3 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 from coming back.”
She added, “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 of Gastrointestinal Cancer Research at the University of Leeds, Professor Matthew Seymour, said, “Timing is everything when it comes to treating colon cancer. The simple act of bringing forward chemotherapy, given 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.”
Professor of Surgery at the University of Birmingham, Professor Dion Morton, 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.”
"Thanks to funding from Cancer Research UK, doctors in countries around the world will now be able to put these findings into clinical practice, saving many thousands of lives.”
The paper, “Preoperative chemotherapy for operable colon cancer: mature results of an international randomised controlled trial,” was published in the Journal of Clinical Oncology.