Transarterial Radioembolization in Patients With Unresectable Colorectal Cancer Liver Metastases
Mené sur 428 patients présentant des métastases hépatiques ayant pour origine un cancer colorectal et ayant reçu un traitement de première intention à base d'oxaliplatine ou d'irinotécan, cet essai randomisé multicentrique de phase III évalue l'efficacité, du point de vue de la survie sans progression et de la survie sans progression hépatique, d'une radio-embolisation transartérielle à l'yttrium-90 en association avec une chimiothérapie systémique de deuxième ligne
The liver is the most common site of colorectal cancer metastasis.1 When isolated liver metastases are present, either presenting synchronous or metachronous to the primary tumor, regional treatments may improve outcomes when added to systemic therapies. When possible, complete resection of colorectal liver metastases (CLM) with fixed-duration chemotherapy is the standard approach. This improves median overall survival (OS) to ≥ 5 years and may cure some patients.2-4 For patients with initially unresectable CLM, systemic chemotherapy with or without a biologic agent is typically used. However, conversion of CLM to resectable is uncommon with systemic therapy alone. Multiple liver-directed therapies have been explored to improve outcomes in patients with CLM in both the first- and later-line settings.
Journal of Clinical Oncology , éditorial en libre accès, 2020