David Sebag-Montefiore, MBBS, MRC, FRCR, FRCP from the University of Leeds, Leeds, UK discusses the positive findings of the RAPIDO (NCT01558921) and FOXTROT studies at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. An interesting aspect of the RAPIDO trial is that the control arm were given chemoradiotherapy, while the experimental arm were give the 5 by 5 approach of radiotherapy, followed by a combination of oxaliplatin-fluoropyrimidine chemotherapy. The advantage of the RAPIDO trial is that they were able to administer neo-adjuvant chemotherapy very early on. The FOXTROT trial (NCT00647530) also used this approach, and produced promising results. This has the greatest chance of producing a cancer benefit, because, although radiotherapy significantly reduces the likelihood of local reoccurrence, the distant metastases are not being treated. He states that the rationale for using the 5 by 5 approach, combined with chemotherapy is very promising, and is strongly supported by these trials.