The FOxTROT trial demonstrated that neoadjuvant chemotherapy (6 weeks FOLFOX) before surgery for high-risk colon cancer (T3–T4) reduced what primary endpoint compared to adjuvant-only treatment?
- A Overall survival at 2 years
- B Tumour regression grade and R0 resection rate
- C 2-year failure-free survival with significant downstaging ✓
- D Anastomotic leak rate
Correct answer: C. 2-year failure-free survival with significant downstaging
Explanation
The FOxTROT trial showed that 6 weeks of neoadjuvant FOLFOX chemotherapy for locally advanced (T3–T4) colon cancer significantly improved 2-year failure-free survival and achieved pathological downstaging (T-stage reduction in ~30%), with acceptable safety. It established neoadjuvant chemotherapy as a viable strategy for high-risk colon cancer, analogous to the rectal cancer model. The trial also evaluated panitumumab addition in RAS wild-type tumours.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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