First-line systemic treatment strategies for initially unresectable colorectal cancer liver metastases

Patients with initially unresectable colorectal cancer liver metastases might qualify for local treatment with curative intent after reducing the tumor size by induction systemic treatment. The phase 3 CAIRO5 trial by the Dutch Colorectal Cancer Group compared the currently most active induction regimens. FOLFOXIRI-bevacizumab appeared to be the preferred treatment in patients with a right-sided or RAS or BRAF^V600E mutated primary tumor. In patients with a left-sided and RAS and BRAF^V600E wild-type tumor, the addition of panitumumab versus bevacizumab to FOLFOX or FOLFIRI did not result in clinical benefit, but was associated with more toxicity.