Neoadjuvant chemotherapy for early-stage colon cancer.

• Surgery +/- adjuvant chemotherapy is the standard of care for early-stage colon cancer. • Four available randomised trials explored neoadjuvant chemotherapy in this setting. • Among these, only the FOxTROT trial met its primary endpoint. • Suboptimal patient selection and overtreatment are important concerns. • Except for selected cases, neoadjuvant chemotherapy remains an investigational approach. Surgery with or without adjuvant chemotherapy is the standard treatment for early-stage colon cancer. However, evidence has recently emerged for neoadjuvant chemotherapy, with the results of randomised clinical trials sparking debates within multidisciplinary teams and splitting the gastrointestinal oncology community. Further to a systematic search of the literature, we provide a thorough and in-depth analysis of the findings from these trials, highlighting the advantages and disadvantages of neoadjuvant chemotherapy. We conclude that, while there is a potential value of moving systemic therapy from the post-operative to the pre-operative setting, the available evidence does not justify a shift in the treatment paradigm of early-stage colon cancer, and surgery with or without adjuvant chemotherapy should remain the standard approach for these patients. [ABSTRACT FROM AUTHOR]