FOxTROT: Randomized phase II study of neoadjuvant chemotherapy with or without an anti-EGFR monoclonal antibody for locally advanced, operable colon cancer.

Abstract

TPS192 Background: For many patients with high-risk, operable colon cancer, surgical excision followed by adjuvant CT fails either to clear locoregional spread or to eradicate distant micrometastases, leading to disease recurrence. Micrometastases may be more readily eradicated by neoadjuvant CT than CT given after the delay and immunological stress of surgery. Shrinking the tumor before surgery may also reduce the risk of incomplete surgical excision, and tumor cell shedding during surgery. Preoperative CT and radiotherapy are surprisingly more effective than postoperative treatment in several other cancers, notably rectal, and neoadjuvant CT has become feasible in colon cancer now that response rates exceed 50% and radiological staging is more accurate. Preoperative CT also provides a unique opportunity to identify tumor markers predictive of response to CT and anti-EGFR therapy. Methods: FOxTROT (Fluoropyrimidine, Oxaliplatin and Targeted Receptor Pre-Operative Therapy) has randomized 98 patients (targ...