Pre-operative chemotherapy for colorectal cancer liver metastases: An update of recent clinical trials

G. Nasti, A. Ottaiano, M. Berretta, P. Delrio, F. Izzo, A. Cassata, C. Romano, G. Facchini, D. Scala, A. Mastro, G. Romano, F. Perri, R. V. Iaffaioli

Research output: Contribution to journalArticlepeer-review


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 progressionfree 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.

Original languageEnglish
Pages (from-to)209-218
Number of pages10
JournalCancer Chemotherapy and Pharmacology
Issue number2
Publication statusPublished - Jul 2010


  • Colorectal cancer
  • Liver metastases
  • Neoadjuvant
  • Resection

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Pharmacology
  • Pharmacology (medical)
  • Toxicology


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