Surgery With or Without Combination Chemotherapy in Treating Patients With Liver Metastases From Colorectal Cancer
Pre- and Post-Operative Chemotherapy With Oxaliplatin 5FU/LV Versus Surgery Alone in Resectable Liver Metastases From Colorectal Origin - Phase III Study
  • Phase

    Phase 3
  • Study Type

  • Status

    Unknown status
  • Intervention/Treatment

    fluorouracil leucovorin oxaliplatin ...
  • Study Participants

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug and combining chemotherapy with surgery may kill more tumor cells. It is not yet known if surgery is more effective with or without chemotherapy for liver metastases.

PURPOSE: Randomized phase III trial to compare the effectiveness of surgery with or without combination chemotherapy in treating patients who have liver metastases from colorectal cancer.

Compare the progression-free and overall survival of patients with resectable colorectal liver metastases treated with surgery with or without neoadjuvant and adjuvant oxaliplatin, fluorouracil, and leucovorin calcium.
Compare the percentage of patients with total resection with these two treatments.

OUTLINE: This is a multicenter study. Patients are stratified according to participating center, prior adjuvant chemotherapy (yes vs no), plasma CEA level in ng/mL at diagnosis of liver metastases (5 or less vs 6 to 30 vs 31 or greater), serosa extension of primary cancer (absent T1 or T2 vs present T3 or T4), lymphatic spread of primary cancer (absent vs present N+), time interval between diagnosis of primary tumor to metastases (2 years or more vs fewer than 2 years), and number of metastases (1 to 3 vs 4). Patients are randomized to one of two treatment arms.

Arm I: Patients receive oxaliplatin IV over 2 hours on day 1 and leucovorin calcium (LV) IV over 2 hours followed by fluorouracil (5-FU) IV over 22 hours on days 1 and 2. Treatment repeats every 15 days for 6 courses in the absence of disease progression or unacceptable toxicity.

At 2 to 5 weeks after chemotherapy, patients undergo liver resection. Patients with progressive disease after 3 courses of chemotherapy undergo liver resection at least 2 weeks after completion of course 3 and do not receive postoperative chemotherapy.

At 2 to 5 weeks after surgery, patients receive oxaliplatin, LV, and 5-FU as in preoperative chemotherapy.

Arm II: Patients undergo liver resection. Patients are followed every 3 months for 2 years and then every 6 months thereafter.

Peer Reviewed and Funded or Endorsed by Cancer Research UK

PROJECTED ACCRUAL: A total of 330 patients (165 per arm) will be accrued for this study within 3 years.
Study Started
Sep 30
Last Update
Apr 18

Drug FOLFOX regimen

Drug fluorouracil

Drug leucovorin calcium

Drug oxaliplatin

Procedure adjuvant therapy

Procedure conventional surgery

Procedure neoadjuvant therapy



Diagnosis of potentially resectable colorectal liver metastases that meets one of the following criteria:

Metachronous metastases after complete resection of primary tumor without gross or microscopic evidence of residual disease
Synchronous metastases after complete resection of primary tumor more than 1 month before study
Synchronous metastases with sufficient evidence (i.e., CAT scan or diagnostic laparoscopy) that both the primary tumor and liver metastases can be completely resected during the same procedure and resection of primary may be delayed 3-4 months



18 to 80

Performance status:

WHO 0-2
Karnofsky 60-100%

Life expectancy:

Not specified


Absolute neutrophil count greater than 1,500/mm^3
Platelet count greater than 100,000/mm^3


No hepatic insufficiency


Creatinine less than 2 times upper limit of normal


No uncontrolled congestive heart failure or angina pectoris
No hypertension or arrhythmia


No other malignancy within the past 10 years except adequately treated carcinoma in situ of the cervix or nonmelanoma skin cancer
No peripheral neuropathy greater than grade 1
No prior significant neurologic or psychiatric disorders
No active infection
Not pregnant or nursing
Fertile patients must use effective contraception


Biologic therapy:

No concurrent biologic therapy


No prior chemotherapy for advanced disease
Prior adjuvant chemotherapy for primary cancer allowed unless included oxaliplatin
No other concurrent chemotherapy

Endocrine therapy:

No concurrent anticancer endocrine therapy


No concurrent radiotherapy


See Disease Characteristics


At least 30 days since prior investigational drugs
No concurrent investigational drugs
No Results Posted