{"entity":{"id":"foxtrot","kind":"trial","name":"FOxTROT","aka":["Fluoropyrimidine, Oxaliplatin and Targeted Receptor pre-Operative Therapy","ISRCTN83842641"],"tldr":"The UK trial that showed giving some chemotherapy before the operation for colon cancer shrinks the tumour, leaves cleaner margins and cuts the chance of the cancer coming back.","summary":"FOxTROT allocated people with locally advanced but operable colon cancer 2:1 to six weeks of preoperative oxaliplatin and fluoropyrimidine chemotherapy or to the standard 24 weeks after surgery. Nearly all who started finished: 674 of 699 began the preoperative course and 606 completed it. Serious postoperative complications were fewer, not more. Resection was histopathologically complete in 94 percent against 89 percent (p < 0.001), and residual or recurrent disease within two years fell from 21.5 percent to 16.9 percent (rate ratio 0.72, 0.54 to 0.98, p = 0.037). Panitumumab added nothing, and mismatch repair deficient tumours gained little. The platform continues as FOxTROT 2 and 3 with the University of Leeds as sponsor, recruiting at 77 centres from Leeds and Glasgow to Velindre and Bangor.","status":"positive","asOf":"2026-09-24","links":[{"label":"Journal of Clinical Oncology 2023","url":"https://europepmc.org/article/MED/36657089"},{"label":"Annals of Oncology 2025: the extended biomarker analysis","url":"https://europepmc.org/article/MED/39805350"},{"label":"ISRCTN83842641","url":"https://www.isrctn.com/ISRCTN83842641"}],"tags":["uk","neoadjuvant","colorectal","platform"],"related":[],"cancers":["colorectal","colon-cancer"],"sections":["chemotherapy","surgery"],"technologies":["cytotoxic-chemotherapy","platinum"],"targets":[],"drugs":["folfox","capox","oxaliplatin","panitumumab","fluorouracil"],"companies":[],"institutions":["birmingham-cancer-centre","leeds-cancer-centre"],"pathways":[],"terms":["neoadjuvant-adjuvant"],"trials":["niche-2"],"people":["dion-morton","matt-seymour"],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"ISRCTN83842641","phase":"3","setting":"Six weeks of preoperative oxaliplatin-fluoropyrimidine chemotherapy plus 18 weeks after surgery, against 24 weeks after surgery alone, in radiologically staged T3-4 N0-2 M0 colon cancer, with a second randomisation to panitumumab in RAS wild-type tumours; the platform continues as FOxTROT 2 and 3 across 77 centres to April 2027","sponsor":"University of Birmingham (original trial); University of Leeds (continuing platform)","result":"Residual or recurrent disease within two years 16.9 percent with six weeks of preoperative chemotherapy against 21.5 percent with postoperative chemotherapy alone (rate ratio 0.72, 0.54 to 0.98, p = 0.037); complete resection 94 percent against 89 percent.","yearReported":2023,"enrolled":1053,"enrolledBasis":"randomised","enrolledNote":"699 patients were allocated to neoadjuvant chemotherapy and 354 to control, 1,053 in total, in the Journal of Clinical Oncology 2023 report; the continuing platform record ISRCTN83842641 carries a target of 1,703.","outcomes":[{"endpoint":"Residual or recurrent disease within 2 years","primary":true,"unit":"percent","arms":[{"name":"Neoadjuvant chemotherapy","n":699,"value":16.9},{"name":"Surgery first","n":354,"value":21.5}],"p":"0.037","source":"https://europepmc.org/article/MED/36657089"}]},"route":"/trials/foxtrot/","neighbours":{"cancer":[{"id":"colon-cancer","kind":"cancer","name":"Colon cancer (adenocarcinoma of the colon)","route":"/cancers/colon-cancer/"},{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"}],"section":[{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"},{"id":"surgery","kind":"section","name":"Surgery & Interventional","route":"/fronts/surgery/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"},{"id":"platinum","kind":"technology","name":"Platinum agents","route":"/technologies/platinum/"}],"drug":[{"id":"capox","kind":"drug","name":"CAPOX (capecitabine, oxaliplatin)","route":"/drugs/capox/"},{"id":"fluorouracil","kind":"drug","name":"Fluorouracil (5-FU)","route":"/drugs/fluorouracil/"},{"id":"folfox","kind":"drug","name":"FOLFOX (5-FU, leucovorin, oxaliplatin)","route":"/drugs/folfox/"},{"id":"oxaliplatin","kind":"drug","name":"Oxaliplatin","route":"/drugs/oxaliplatin/"},{"id":"panitumumab","kind":"drug","name":"Panitumumab","route":"/drugs/panitumumab/"}],"institution":[{"id":"leeds-cancer-centre","kind":"institution","name":"Leeds Cancer Centre, St James's University Hospital","route":"/institutions/leeds-cancer-centre/"},{"id":"birmingham-cancer-centre","kind":"institution","name":"University Hospitals Birmingham / University of Birmingham Cancer Research Centre","route":"/institutions/birmingham-cancer-centre/"}],"term":[{"id":"neoadjuvant-adjuvant","kind":"term","name":"Neoadjuvant / adjuvant / perioperative","route":"/terms/neoadjuvant-adjuvant/"}],"trial":[{"id":"niche-2","kind":"trial","name":"NICHE-2","route":"/trials/niche-2/"}],"person":[{"id":"dion-morton","kind":"person","name":"Dion Morton","route":"/people/dion-morton/"},{"id":"matt-seymour","kind":"person","name":"Matt Seymour","route":"/people/matt-seymour/"}]}}