Chemotherapy before surgery ‘cuts risk of bowel cancer recurrence by 28%’

Experts welcomed “extraordinary” new research showing that giving chemotherapy before surgery for early-stage bowel cancer reduces the chance of recurrence by 28%.

The Cancer Research UK-funded study suggests that at least 5,000 patients in the UK each year could benefit from a fine-tuning of the way they receive chemotherapy.

Currently, chemotherapy is given after surgery to try to catch any stray cancer cells that could cause the disease to come back.

But under the new regimen, patients would receive six weeks of chemotherapy, surgery, and then another 18 weeks of chemotherapy, which would have the effect of giving people a chance to beat the disease.

The FOxTROT trial, conducted by the universities of Birmingham and Leeds, included 1,053 patients in 85 hospitals in England, Denmark and Sweden.

He found that giving chemotherapy before and after surgery reduced the risk of recurrence of the disease within two years by 28% compared to chemotherapy after surgery.

During the study, the first group of patients received six weeks of chemotherapy, followed by surgery, followed by 18 weeks of chemotherapy.

The second group received regular treatment for bowel cancer (also known as colon cancer), which included surgery followed by 24 weeks of chemotherapy.

The findings showed that patients who received chemotherapy before surgery were significantly less likely to have their cancers relapsed.

Scientists believe this approach could be adopted across the NHS and in countries around the world, benefiting hundreds of thousands of patients each year.

Dr Laura Magill, associate professor in the Birmingham clinical trials unit, said: “One in three colon cancer patients may find that their cancer has returned after surgery.

“This figure is very high and we need new treatment strategies to stop colon cancer recurrence.

“The standard approach has been to give chemotherapy after surgery to destroy any cancer cells that may have spread before the surgery.

“But our research shows that giving some of this chemotherapy before surgery increases the chance that all cancer cells will be killed.

“A growing body of evidence shows the value of preoperative chemotherapy in some other cancers, and we believe our results could change our approach to colon cancer in the clinic.”

In total, 699 patients in the trial received chemotherapy before surgery.

Professor Matthew Seymour of the University of Leeds said: “When it comes to colon cancer treatment, timing is everything.

“The simple act of giving chemotherapy before surgery, giving it after surgery is producing some remarkable results.

“Giving chemotherapy before surgery can prevent cancer recurrence without the need for expensive new drugs or technologies.

“It was particularly encouraging to find that patients who received chemotherapy prior to surgery experienced fewer surgical complications.

“Expanding this treatment worldwide, including in low- and middle-income countries, could change cancer care and save thousands of lives.”

Scientists are conducting two more clinical trials to investigate whether older patients also benefit from chemotherapy prior to surgery: FOxTROT-2 and FOxTROT-3.

Geoff Hoggard of Leeds was diagnosed with bowel cancer in 2016 and joined the cause.

“I had chemo for six weeks before surgery and 18 weeks after surgery, which was so hard… It was worth it in the end.”

There are around 42,900 new cases of bowel cancer in the UK each year.

It is the fourth most common cancer in the UK and accounts for 11% of all new cancer cases.

Genevieve Edwards, CEO of Bowel Cancer UK, said: “It’s great to see such positive results from this powerful trial that we are following with great interest.

“Great news that has the potential to make a real difference in the lives of thousands of people diagnosed with early-stage bowel cancer each year.”

He said the charity looks forward to continuing the case for longer.

“One person dies from bowel cancer every 30 minutes in the UK, so continuing to find new ways to treat the disease is crucial to saving more lives.”

The research was published in the Journal of Clinical Oncology.

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