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Neoadjuvant Chemotherapy vs Upfront Surgery in Patients With Locally Advanced Colon Cancer: A Randomized Clinical Trial - PubMed

11 hours ago
  • #neoadjuvant chemotherapy
  • #clinical trial
  • #colon cancer
  • Neoadjuvant chemotherapy was compared to upfront surgery in patients with locally advanced colon cancer in a phase III randomized clinical trial.
  • The trial involved 250 patients from Denmark, Norway, and Sweden, with a median age of 66 years.
  • Primary outcome was disease-free survival (DFS), which showed no significant difference between the two groups (87% for upfront surgery vs. 83% for neoadjuvant chemotherapy).
  • Neoadjuvant chemotherapy was found to be feasible and safe, leading to tumor downstaging and reduced need for adjuvant chemotherapy.
  • Exploratory analyses suggested potential differences in outcomes based on mismatch repair (MMR) status, with better DFS for MMR-deficient tumors after upfront surgery.
  • Postoperative complications, adverse events, and quality of life were similar between both treatment groups.
  • The trial concluded that neoadjuvant chemotherapy did not improve DFS over upfront surgery but highlighted its role in reducing adjuvant therapy use and tumor downstaging.