Initially unresectable colorectal liver metastases: the best therapeutic regimens

Mené sur 530 patients atteints d'un cancer colorectal et présentant des métastases hépatiques (âge médian : 62 ans), cet essai multicentrique de phase III compare l'efficacité, du point de vue de la survie sans progression, et la toxicité de différentes stratégies d'induction (FOLFOX, FOLFIRI ou FOLFOXIRI avec bévacizumab ou panitumumab)

Résumé en anglais

Despite the advances in systemic chemotherapy and molecular targeted therapy, local treatment, including resection and local ablative treatment, is the only treatment of choice that can provide prolonged survival in patients with colorectal liver metastases. Therefore, for initially unresectable colorectal liver metastases, a sufficient response to optimal systemic chemotherapy with biological targeted drugs to allow subsequent surgical treatment would be an important development and could lead to improvemnts in long-term survival. However, the diversity of this complex disease, including molecular and genetic alterations and embryologic origin of the primary tumour, the small number of trials, and the absence of a universal definition for surgical resectability or unresectability complicates the development of a consensus on optimal therapeutic approaches.