Pre-operative chemotherapy for colorectal cancer liver metastases: an update of recent clinical trials
- 24 March 2010
- journal article
- review article
- Published by Springer Science and Business Media LLC in Cancer Chemotherapy and Pharmacology
- Vol. 66 (2), 209-218
- https://doi.org/10.1007/s00280-010-1297-x
Abstract
The standard treatment of CRC patients with hepatic metastases is systemic chemotherapy; however, 5-year survival is disappointingly poor despite recent advances. On the other hand, in patients who undergo immediate radical surgical resection of hepatic metastases, 5-year survival reaches 30–40%. Unfortunately, only 15–20% of patients with hepatic metastases are initially eligible for a radical surgical approach. The majority of patients undergoing liver resection relapse after surgery. For this reason, new onco-surgery approaches have been investigated in recent years and the addition of biological agents to chemotherapy, such as bevacizumab and cetuximab, and the improvements of surgical techniques have opened a new scenario in the management of colorectal liver metastases. Recently, the EORTC trial has demonstrated that perioperative chemotherapy (Folfox regimen) is feasible and improves progression-free survival in patients with resectable liver metatsases. Chemotherapy and surgery can finally collaborate. In the unresectable setting, the association of chemotherapy with bevacizumab and cetuximab is particularly promising in improving resectability rate. In particular, K-RAS is a molecular response predictive factor that could be particularly useful in selecting the best treatment option in patients with unresectable liver disease.Keywords
This publication has 44 references indexed in Scilit:
- Tumour response and secondary resectability of colorectal liver metastases following neoadjuvant chemotherapy with cetuximab: the CELIM randomised phase 2 trialThe Lancet Oncology, 2010
- Cetuximab and Chemotherapy as Initial Treatment for Metastatic Colorectal CancerThe New England Journal of Medicine, 2009
- Bevacizumab in Combination With Oxaliplatin-Based Chemotherapy As First-Line Therapy in Metastatic Colorectal Cancer: A Randomized Phase III StudyJournal of Clinical Oncology, 2008
- Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trialThe Lancet, 2008
- Complete Response of Colorectal Liver Metastases After Chemotherapy: Does It Mean Cure?Journal of Clinical Oncology, 2006
- Cancer Statistics, 2004CA: A Cancer Journal for Clinicians, 2004
- A Randomized Controlled Trial of Fluorouracil Plus Leucovorin, Irinotecan, and Oxaliplatin Combinations in Patients With Previously Untreated Metastatic Colorectal CancerJournal of Clinical Oncology, 2004
- Five-Year Survival Following Hepatic Resection After Neoadjuvant Therapy for Nonresectable Colorectal [Liver] MetastasesAnnals of Surgical Oncology, 2001
- Resection of Nonresectable Liver Metastases from Colorectal Cancer After Neoadjuvant ChemotherapyAnnals of Surgery, 1996
- Resection of colorectal liver metastasesWorld Journal of Surgery, 1995