A change to the standard of care protocol for colon cancer reduces the risk of recurrence by 28%. The good news comes from a British clinical study published in the Journal of Clinical Oncology: in patients with colorectal cancer still in the early stage, also carry out chemotherapy primaand not only after the tumor removal surgery greatly improves the chances of definitive cure.
The current protocol. Colorectal cancer represents 10% of all cancers diagnosed in the world, and in one out of three cases the disease returns some time after initial treatment. After diagnosis, the most common therapy involves surgery followed by the so-called adjuvant chemotherapya chemo performed following the operation to eliminate any residual cancer cells that escaped the irons and diagnostic tests.
In a smaller number of cases, chemo instead precedes surgery (neoadjuvant therapy), but this is usually to reduce the size of the tumor and make it easier to remove.
right away A taste of chemo. In the FOxTROT clinical trial coordinated by the Universities of Birmingham and Leeds and funded by Cancer Research UK, it was thought to use pre-intervention chemotherapy even in cases of colorectal cancer still in the initial stage, in which theoretically it would not be necessary to shrink the lesion before removing it.
The study involved 1,053 patients being treated in the UK, Sweden and Denmark who were divided into two groups. In the first, the new approach was tested, which involves six weeks of chemotherapy, followed by the operation and another 18 weeks of chemo. The patients in the second group, on the other hand, observed the standard protocol, i.e. surgery immediately, followed by 24 weeks of chemotherapy.
An exportable tactic. The first strategy resulted in a 28% lower occurrence of relapses two years after diagnosis than the usually used approach. This is important news because, as the scientists write, six weeks of chemotherapy in early stage tumors is a “short” period enough to be safely offered to patients, without the disease significantly worsening before the operation – with the risk to become inoperable.
“More and more studies show the value of preoperative chemotherapy in several other types of cancer, and we think our findings could transform the way we treat colon cancer in the clinical setting,” said Laura Magill, co-author of the study.
NEAR future. Given the positive effects and the ease of modifying the treatment, which does not involve new drugs or expensive technologies, the hope is that the approach can now become more widespread.
“By expanding this treatment to other parts of the world, including low- and middle-income countries, we could transform cancer care and save many thousands of lives,” Magill concludes.