# CAIRO5

Source: https://onco.cc/trials/cairo5/  
OnCo record `cairo5` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The trial that chose the best chemotherapy for shrinking liver metastases enough to operate, using a panel of surgeons to judge resectability every two months.

## Summary

CAIRO5 enrolled 530 patients with initially unresectable colorectal liver metastases at 46 Dutch and one Belgian centre, with resectability judged centrally by a panel of liver surgeons and radiologists at baseline and every two months. Patients with a right-sided primary or a RAS or BRAF V600E mutation were randomised to a doublet plus bevacizumab (group A) or FOLFOXIRI plus bevacizumab (group B); those with a left-sided RAS and BRAF wild-type tumour to a doublet plus bevacizumab (group C) or plus panitumumab (group D). Median progression-free survival was 9.0 against 10.6 months in groups A and B (hazard ratio 0.76, 95% CI 0.60 to 0.98, p=0.032) and 10.8 against 10.4 months in groups C and D (1.11, 0.84 to 1.48, p=0.46); groups C and D were closed early for futility. Neutropenia was much more common with the triplet (40 against 13 percent). The conclusion is FOLFOXIRI plus bevacizumab for right-sided or RAS/BRAF-mutant liver-limited disease, and bevacizumab rather than panitumumab for left-sided wild-type disease in this setting.

## Fields

- Kind: Trial
- Status: mixed
- Last checked: 2026-09-24
- Registry id: NCT02162563
- Phase: 3
- Setting: Initially unresectable colorectal liver metastases, stratified by sidedness and RAS/BRAF status: a doublet plus bevacizumab, FOLFOXIRI plus bevacizumab, or a doublet plus panitumumab, with central resectability review every two months
- Sponsor: Dutch Colorectal Cancer Group
- Enrolled: 530
- Result: FOLFOXIRI plus bevacizumab better than a doublet for right-sided or RAS/BRAF-mutant disease; panitumumab no better than bevacizumab for left-sided wild-type disease.
- Outcomes: Progression-free survival (right-sided or RAS/BRAF mutant): FOLFOXIRI plus bevacizumab 10.6 months vs Doublet plus bevacizumab 9 months, HR 0.76; Progression-free survival (left-sided, RAS and BRAF wild-type): Doublet plus panitumumab 10.4 months vs Doublet plus bevacizumab 10.8 months, HR 1.11

## Sources

- ClinicalTrials.gov NCT02162563: https://clinicaltrials.gov/study/NCT02162563
- CAIRO5: first-line systemic treatment strategies in initially unresectable colorectal cancer liver metastases (Lancet Oncology 2023): https://doi.org/10.1016/S1470-2045(23)00219-X

## Connected records

- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/)
- technologies: [Anti-angiogenic therapy](https://onco.cc/technologies/antiangiogenic/), [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Monoclonal antibodies](https://onco.cc/technologies/monoclonal-antibody/)
- targets: [BRAF](https://onco.cc/targets/braf/), [EGFR](https://onco.cc/targets/egfr/), [KRAS](https://onco.cc/targets/kras/), [VEGF / VEGFR](https://onco.cc/targets/vegf/)
- drugs: [Bevacizumab](https://onco.cc/drugs/bevacizumab/), [FOLFIRI (5-FU, leucovorin, irinotecan)](https://onco.cc/drugs/folfiri/), [FOLFOX (5-FU, leucovorin, oxaliplatin)](https://onco.cc/drugs/folfox/), [FOLFOXIRI (5-FU, leucovorin, oxaliplatin, irinotecan)](https://onco.cc/drugs/folfoxiri/), [Panitumumab](https://onco.cc/drugs/panitumumab/)
- terms: [Hepatectomy (liver resection)](https://onco.cc/terms/hepatectomy/), [Oligometastatic disease](https://onco.cc/terms/oligometastatic/), [Sidedness (left vs right colon)](https://onco.cc/terms/sidedness/)
- trials: [EORTC 40983](https://onco.cc/trials/eortc-40983/), [PARADIGM](https://onco.cc/trials/paradigm/), [TRIBE](https://onco.cc/trials/tribe/)

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