Last updated on April 2020

Systemic Oxaliplatin or Intra-arterial Chemotherapy Combined With LV5FU2 and an Target Therapy in First Line Treatment of Metastatic Colorectal Cancer Restricted to the Liver


Brief description of study

Colorectal cancer is the 3rd most common cancer in France and the 2nd cause of death from cancer. Between 30 to 60% of patients develop limited or predominant liver metastases. Surgical resection of these metastases, only curative treatment is not immediately possible in 10-15% of cases. In unresectable patients, current palliative treatments are based on systemic chemotherapy associated or not with the targeted therapies (anti-EGFR (panitumumab), anti-VEGF (bevacizumab)). In this patient population, special attention was paid to intensified treatment regimens in order to improve their efficiency and improving the tumoral response rate, the intensity of the response and its earliness correlate with improved overall and progression-free survival.

The intra-arterial use of oxaliplatin coupled with IV chemotherapy has yielded OR levels of 64% in patients having survived one or more lines of chemotherapy IV and 62% in patients who have progressed on oxaliplatin IV. In addition, the HIA administration of oxaliplatin limits systemic and especially neurological toxicities, thanks to a greater hepatic clearance.

In conclusion, the combination of systemic chemotherapy, targeted therapy and HIAC with oxaliplatin has showed promising efficacy results associated with good tolerance from the first line onwards. Indeed, we can expect from the Phase II recent data, a control rate close to 100%, with high response rates associated with early maturity and depth responses as well as prolonged survival. However, to date, in the absence of randomized trial testing this combination, this strategy does not have sufficient evidence to be integrated in our routine practices, and HIAC remains limited to a few expert centers in treatment catch-up.

Clinical Study Identifier: NCT02885753

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CH D'Abbeville

Abbeville CEDEX, France
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CHU

Angers, France
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CH d'Auxerre

Auxerre, France
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CH C te Basque

Bayonne CEDEX, France
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CH Jean Minjoz

Besançon, France
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Institut Bergoni

Bordeaux CEDEX, France
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CMCO C te d'Opale

Boulogne-sur-Mer, France
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H pital Duchenne

Boulogne-sur-Mer, France
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CH William Morey

Chalon-sur-Saône, France
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H pital Priv Sainte Marie

Chalon-sur-Saône, France
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Clinique Saint C me

Compiègne CEDEX, France
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H pital Henri Mondor

Créteil CEDEX, France
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Chd Vendee

La Roche Sur Yon, France
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H pital de Bic tre

Le Kremlin-Bicêtre, France
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CH du Mans

Le Mans CEDEX 9, France
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H pital Francobritannique

Levallois-Perret, France
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Samy LOUAFI

Longjumeau, France
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CHU La Timone

Marseille CEDEX 5, France
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Centre Hospitalier

Montceau-les-Mines, France
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Centre Hospitalier

Montélimar, France
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CHR

Orleans, France
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HEGP

Paris, France
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CH

Perpignan, France
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CH Lyon Sud

Pierre-Bénite CEDEX, France
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CHU

Poitiers, France
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CH Ren Dubois

Pontoise, France
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CHIC

Quimper, France
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CHU Robert Debr

Reims CEDEX, France
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CHU de Pont Chaillou

Rennes CEDEX 9, France
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H pital Drome Nord

Romans-sur-Isère, France
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CHU Charles Nicolle

Rouen CEDEX 01, France
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Clinique Trenel

Sainte Colombe, France
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CH

Senlis CEDEX, France
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CH

Soissons CEDEX, France
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H pitaux du Leman

Thonon-les-Bains, France
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CHU Nancy-Brabois

Vandœuvre-lès-Nancy, France
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Recruitment Status: Open


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