Intraperitoneal Irinotecan With Concomitant FOLFOX and Bevacizumab

Inclusion Criteria:

• Histologically confirmed colorectal cancer;
• Radiologically and clinically or pathologically confirmed unresectable colorectalperitoneal metastases (e.g. PCI >20, extensive small bowel involvement, unresectabledisease due to anatomical location);
• WHO performance score of 0-1 with a life expectancy of >3 months;
• Aged 18 years or older;
• Written informed consent;

Exclusion Criteria:

• Presence of extensive systemic metastases that are deemed to be the dominant factordetermining prognosis in terms of life expectancy and performance status [e.g. noimminent threat of impaired organ functioning due to the presence of systemicmetastases]);
• Prior cytoreductive surgery;
• Prior palliative systemic therapy for colorectal cancer;
• Prior neo-adjuvant/adjuvant systemic therapy for colorectal cancer within the last 6months;
• Homozygous UGT1A1*28 genotype;
• Homozygous dihydropyrimidine dehydrogenase (DPD) deficiency
• Microsatellite instable (MSI) primary tumor
• Any contra-indication for the planned chemotherapy (e.g. active infection, seriousconcomitant disease, severe allergy), as determined by the medical oncologist;
• Inadequate organ functions, defined as an haemoglobin of <5 mmol/L, an absoluteneutrophil count of <1.5 x 109/L, platelet count of <100 x 109/L, serum creatinine of >1.5 x ULN, creatinine clearance of <30 ml/min, Bilirubin > 2x ULN and livertransaminases of >5 x ULN.