FOLFOX/FOLFIRI–Bevacizumab for Unresectable Colorectal Liver Metastases

Mené sur 530 patients atteints d'un cancer colorectal non résécable et présentant des métastases hépatiques (âge médian : 62 ans), cet essai multicentrique de phase III analyse l'efficacité, du point de vue de la survie globale, de 3 stratégies thérapeutiques de première ligne (FOLFOXIRI + bevacizumab / FOLFOX/FOLFIRI + bevacizumab / FOLFOX/FOLFIRI + panitumumab)

Résumé en anglais

Approximately 80% of patients with metastatic colorectal cancer (mCRC) have liver metastases. Even if the liver is the sole distant site involved, most patients have cancer that is initially unresectable. The study by Bond et al, published in JAMA Oncology, resolves a previously unmet knowledge gap regarding initial systemic therapy.The presented data support using leucovorin calcium, 5-fluorouracil (5-FU), and oxaliplatin (FOLFOX)/leucovorin calcium, 5-FU, and irinotecan (FOLFIRI)–bevacizumab in patients with initially unresectable colorectal liver-only metastases, irrespective of RAS/BRAFV600E variant status and tumor sidedness. Data from the CAIRO5 randomized clinical trial should streamline discussions with a clearly defined intent to convert initially unresectable liver-only metastases to resectable, thus achieving synergy between systemic and surgical therapies.