The FOxTROT Programme

What is the difference between FOxTROT and current bowel cancer treatments?

For many years, the standard treatment for patients with bowel cancer has been to have surgery to remove the tumour. The aim of the anti-cancer medicine (chemotherapy) is to kill off any remaining cancerous cells not removed by the surgery.

Our FOxTROT 1 research showed that giving some chemotherapy before surgery (called ‘neoadjuvant’ chemotherapy) was safe for bowel cancer patients, reduced complications following surgery and reduced the chances of their cancer coming back. The approach has become a standard treatment option under NICE (the National Institute for Health and Care Excellence) guidelines for those patients who are younger and fitter and who have fewer other medical conditions.

We now want to find out if the neoadjuvant approach can:

  • offer better treatment for older patients or those with other significant medical conditions – FOxTROT 2.
  • be ‘intensified’ to improve outcomes for younger, fitter patients – FOxTROT 3

FOxTROT 2 and FOxTROT 3 – Key Differences

The key difference between FOxTROT 2 and standard treatment is not in the surgery or the chemotherapy medicines used, but WHEN they are used. Instead of undergoing the surgery first, followed by chemotherapy, some patients in FOxTROT 2 will receive part of the chemotherapy before surgery and some patients will receive the standard approach of having surgery first.

The key difference in FOxTROT 3 is not in the surgery but the neoadjuvant chemotherapy medicines used. Patients in the FOxTROT 3 approach will receive either ‘intensified’ neoadjuvant chemotherapy (three chemotherapy medicines) or dual neoadjuvant chemotherapy (two chemotherapy medicines). Patients will receive further chemotherapy after surgery.