The results showed that it is useful to have some chemotherapy before surgery for bowel cancer. It didn’t cause any more side effects or issues after surgery.
Trial design
This trial was for people who were due to have surgery and chemotherapy for bowel cancer that had not spread.
They were put into a treatment group at random. One group had chemotherapy before and after surgery. The other had chemotherapy after surgery, but not before. People in both groups had the same amount of chemotherapy in total.
Results
A total of 1,053 people joined this trial:
- 699 people had some chemotherapy before and some after surgery
- 354 people had surgery and then chemotherapy
Some people who had chemotherapy before their operation also had panitumumab.
Most people taking part had surgery as planned. The trial team looked at whether they could remove all of the cancer and a small area around it (the margin). They call this a complete resection.
They found they could remove it all in:
- 648 out of 686 people (94%) who had treatment before surgery
- 311 out of 351 people (89%) who didn’t have treatment before surgery
They also looked at how many people had signs of bowel cancer, 2 years after they joined the trial. They found it was:
- 117 out of 699 people (17%) in the group having treatment before surgery
- 75 out of 354 (21%) in the group not having treatment before surgery
This means that having some treatment before surgery stopped 1 in 5 cancers coming back. There was still a benefit 5 years after treatment.
Problems after surgery
They also looked at how many people had problems after their operation. This included things such as:
- an infection
- a leak where the ends of the colon are joined back together
- needing to have a second operation
- staying in hospital longer than expected
These were all low in both groups. But they were lower in the group who had treatment before their operation.
Panitumumab
The team found that overall, chemotherapy and panitumumab didn’t work better than chemotherapy alone.
They plan to publish more results about this part of the trial at a later date.
Conclusion
The trial team concluded that having some chemotherapy before and some after surgery is better than having all the chemotherapy afterwards. This is for people with bowel cancer that has not spread.
They also concluded there was no extra benefit to having panitumumab as well as chemotherapy before surgery.
They suggest doctors should consider giving some chemotherapy before surgery for this group of patients.
More detailed information
There is more information about this research in the references below.
Please note, these articles are not in plain English. They have been written for health care professionals and researchers.
FOxTROT: an international randomised controlled trial in 1052 patients (pts) evaluating neoadjuvant chemotherapy (NAC) for colon cancer.
M Seymour and others
Journal of Clinical Oncology, 2019. Volume 37, issue 15 supplement
Preoperative Chemotherapy for Operable Colon Cancer: Mature Results of an International Randomized Controlled Trial
D Morton and others
Journal of Clinical Oncology. Published online, January 2023.
Where this information comes from
We have based this summary on the information in the articles above. These have been reviewed by independent specialists (peer reviewed 
) and published in medical journals. We have not analysed the data ourselves.
