FOxTROT trial sheds light on neoadjuvant therapy for colorectal cancer. MedTwitter OncTwitter
I'm David Kerr, professor of cancer medicine from University of Oxford. I'd like to discuss a trial that's popped up recently in the. This is a trial of neoadjuvant chemotherapy vs conventional adjuvant chemotherapy in patients with colon cancer.
I found the chemotherapy description a bit confusing because at one stage, they were considering 2:2 randomization in which some patients received panitumumab, and it looked as if some patients could get capecitabine and oxaliplatin. That would be two cycles of CAPOX, capecitabine/oxaliplatin, given in 3-weekly intervals and the remainder given subsequently.
In those patients who undergo surgery and then receive full histopathologic review, of course, there'll be some patients who'll be found to have very early stage T3N0 disease. In that setting, it's quite possible that the clinician and patient would decide that chemotherapy wasn't in their best interest. There was a mismatch in the numbers, with fewer patients getting chemotherapy in the adjuvant arm.
In our practice, we were not rushing to engage giving neoadjuvant chemotherapy routinely — far from it.
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