INDIA HOSPITAL NETWORK LAUNCHED TO INITIATE LIFE-SAVING COLON CANCER TRIAL
Twelve hospitals across India will be part of the network which will support the trial in India
Cancer surgery experts on Friday launched a network of hospitals across India to support a countrywide clinical trial exploring how giving colon cancer patients chemotherapy before surgery cuts their risk of the disease coming back.
The Cancer Research Uk-funded FOXTROT trial showed that patients who had chemotherapy before surgery were significantly less likely to see their cancer come back, compared with those who got all their chemotherapy after surgery. Led by expert cancer specialists in India, supported by Universities of Birmingham and Leeds, FOXTROTGLOBAL is a pilot study, being run from India, in parallel to the on-going FOXTROT2 trial open in the UK and France – allowing experts to look at the feasibility and safety of conducting a subsequent full trial in Indian patients. Launched at G B Pant Hospital, in Delhi, 12 hospitals across India including Tata Memorial Hospital Mumbai, and Tata Medical Centre Kolkata have proposed to be part of the FOXTROT-GLOBAL as part of the FOXTROT2 Global trial - an international trial running in parallel in multiple countries across the world.
Dion Morton, Professor of Surgery at the University of Birmingham said: “Colon cancer is the fourth most common cancer worldwide and accounts for 10% of cancer deaths worldwide. Whilst treatment can cure half of affected patients, many older and frailer patients still die from the disease. “Post-operative chemotherapy is sometimes not considered beneficial for frail patients because of the adverse side effects, but providing a shorter course of chemotherapy before surgery would overcome many obstacles. We believe that frailer or older patients, may benefit from this novel approach.”
Reducing colon cancer returning
1,053 colon cancer patients from 85 hospitals in the UK, Denmark and Sweden were involved in the initial FOXTROT trial, also led by scientists at Birmingham and Leeds. The researchers discovered that delivering chemotherapy before surgery reduced the chance of colon cancer returning within two years by 28%. The scientists believe that giving chemotherapy to bowel cancer patients before surgery could be easily adopted in India and other health systems across the world, with over 10,000 patients every year in India alone who could benefit from this treatment. The study will be co-ordinated by experts at the NIHR Global Surg India Hub – based at Ludhiana – part of a global surgical research network funded by the UK’S National Institute for Health Research (NIHR) and led by the University of Birmingham with Hubs in Benin, Ghana, India, Mexico, Nigeria, Rwanda and South Africa.
Dr Laura Magill, Associate Professor at the Birmingham Clinical Trials Unit at the University of Birmingham said: “Up to 1 in 3 colon cancer patients can see their cancer come back after surgery. That figure is far too high and we need new treatment strategies to stop colon cancer coming back.
“The standard approach has been to give chemotherapy after surgery to eradicate any cancer cells that might have spread before surgery, but our research shows that giving some of that chemotherapy before surgery increases the chances that all cancer cells will be killed. “A growing body of evidence is showing the value of pre-operative chemotherapy in several other cancers, and we believe that our results could transform how we approach colon cancer in the clinic.” FOXTROT 2 India may provide much needed, high-quality randomised data to evaluate whether a larger trial is needed. A key consideration for FOXTROT-GLOBAL is patient selection and deciding which patients are older or frail. The most likely participants will be patients with advanced operable colon cancer likely to require post-surgical chemotherapy, but who not be suitable to receive or unlikely to complete such treatment chemotherapy due to frailty or comorbidities.