Radiological approaches to personalise neoadjuvant therapies in colon cancer

Colon cancer (CC) is the fourth most common cancer type worldwide, with over one million new diagnoses each year. Although localised disease can be cured with a combination of surgery and adjuvant chemotherapy, up to 30% of patients experience disease recurrence, with unacceptable levels of subsequent mortality. Neoadjuvant therapies represent a much-needed breakthrough in CC treatment, exemplified by the recent FOxTROT trial which has established neoadjuvant chemotherapy (NAC) as a new treatment option for locally advanced disease.

The use of NAC in CC represents a major shift in practice with several challenges to wider clinical implementation. This transition has introduced several potential new roles for radiology in prognostication, patient stratification and response evaluation. Yet, the evidence supporting these applications is underdeveloped, particularly as CC enters an era of precision oncology. The aims of this thesis are to explore the roles of radiology in the neoadjuvant setting, identify opportunities to personalise treatment and provide clinically relevant data to inform future clinical practice and trial design.