Chemotherapy increases survival of colorectal cancer patients with inoperable liver metastasis

This study investigated the benefits of chemotherapy in colorectal cancer patients with inoperable liver metastasis (the cancer has spread to the liver). Researchers reported that chemotherapy increases survival in colorectal patients with inoperable liver metastasis. 

Only 10-20% of colorectal patients with liver metastasis undergo surgery. A recent study suggested that chemotherapy combined with cetuximab (Erbitux) increased the survival rate by decreasing the size of the liver metastasis compared to chemotherapy alone in patients with inoperable liver metastasis. However, this study has a small number of participant patients and did not include colorectal cancer patients with KRAS mutation (a change in KRAS gene that increases tumour growth). It is not clear whether conversion chemotherapy (used to shrink a tumor in order to increase the chances of surgery) affects survival.

The objective of this study was to investigate the impact on survival of different chemotherapies for changing inoperable liver metastasis to operable.

This study included information on 104 colorectal cancer patients with inoperable liver metastasis. 29.8% of the patients carried a KRAS mutation. Patients were treated with chemotherapy alone (group 1), chemotherapy combined with bevacizumab (Avastin, group 2) and chemotherapy combined with cetuximab (group 3). Group 3 did not included KRAS mutation patients. Disease-free survival (DFS, time from liver surgery to relapse or death), overall survival (OS, time from treatment to death by any cause) and progression-free survival (PFS, time to disease progression) were measured.

After chemotherapy, 43.3% of group 1, 30.7% of group 2 and 51.4% of group 3 were able to undergo surgery. The OS was 35.2 months for group 1, 28.8 months in group 2 and 42.1 months in group 3. PFS was 13.6 months in group 1, 13 in group 2 and 15.4 in group 3. DFS was 9.8 months in group 1, 11 in group 2 and 5.5 in group 3. Patients who were able to convert to liver surgery were more likely to have a longer survival time than patients who did not undergo surgery.

This study showed that colorectal cancer patients with inoperable liver metastasis treated with chemotherapy combined with cetuximab were more likely to have tumor shrinkage and increased survival.