{"entity":{"id":"cairo5","kind":"trial","name":"CAIRO5","aka":[],"tldr":"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.","status":"mixed","asOf":"2026-09-24","links":[{"label":"ClinicalTrials.gov NCT02162563","url":"https://clinicaltrials.gov/study/NCT02162563"},{"label":"CAIRO5: first-line systemic treatment strategies in initially unresectable colorectal cancer liver metastases (Lancet Oncology 2023)","url":"https://doi.org/10.1016/S1470-2045(23)00219-X"}],"tags":[],"related":[],"cancers":["colorectal"],"sections":[],"technologies":["cytotoxic-chemotherapy","antiangiogenic","monoclonal-antibody"],"targets":["vegf","egfr","kras","braf"],"drugs":["folfoxiri","folfox","folfiri","bevacizumab","panitumumab"],"companies":[],"institutions":[],"pathways":[],"terms":["sidedness","hepatectomy","oligometastatic"],"trials":["tribe","eortc-40983"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"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","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.","yearReported":2023,"enrolled":530,"enrolledBasis":"registry","outcomes":[{"endpoint":"Progression-free survival (right-sided or RAS/BRAF mutant)","primary":true,"unit":"months","arms":[{"name":"FOLFOXIRI plus bevacizumab","n":144,"value":10.6},{"name":"Doublet plus bevacizumab","n":147,"value":9}],"hr":0.76,"ci":[0.6,0.98],"p":"0.032","source":"https://doi.org/10.1016/S1470-2045(23)00219-X"},{"endpoint":"Progression-free survival (left-sided, RAS and BRAF wild-type)","unit":"months","arms":[{"name":"Doublet plus panitumumab","n":116,"value":10.4},{"name":"Doublet plus bevacizumab","n":114,"value":10.8}],"hr":1.11,"ci":[0.84,1.48],"p":"0.46","source":"https://doi.org/10.1016/S1470-2045(23)00219-X"}]},"route":"/trials/cairo5/","neighbours":{"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"}],"technology":[{"id":"antiangiogenic","kind":"technology","name":"Anti-angiogenic therapy","route":"/technologies/antiangiogenic/"},{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"},{"id":"monoclonal-antibody","kind":"technology","name":"Monoclonal antibodies","route":"/technologies/monoclonal-antibody/"}],"target":[{"id":"braf","kind":"target","name":"BRAF","route":"/targets/braf/"},{"id":"egfr","kind":"target","name":"EGFR","route":"/targets/egfr/"},{"id":"kras","kind":"target","name":"KRAS","route":"/targets/kras/"},{"id":"vegf","kind":"target","name":"VEGF / VEGFR","route":"/targets/vegf/"}],"drug":[{"id":"bevacizumab","kind":"drug","name":"Bevacizumab","route":"/drugs/bevacizumab/"},{"id":"folfiri","kind":"drug","name":"FOLFIRI (5-FU, leucovorin, irinotecan)","route":"/drugs/folfiri/"},{"id":"folfox","kind":"drug","name":"FOLFOX (5-FU, leucovorin, oxaliplatin)","route":"/drugs/folfox/"},{"id":"folfoxiri","kind":"drug","name":"FOLFOXIRI (5-FU, leucovorin, oxaliplatin, irinotecan)","route":"/drugs/folfoxiri/"},{"id":"panitumumab","kind":"drug","name":"Panitumumab","route":"/drugs/panitumumab/"}],"term":[{"id":"hepatectomy","kind":"term","name":"Hepatectomy (liver resection)","route":"/terms/hepatectomy/"},{"id":"oligometastatic","kind":"term","name":"Oligometastatic disease","route":"/terms/oligometastatic/"},{"id":"sidedness","kind":"term","name":"Sidedness (left vs right colon)","route":"/terms/sidedness/"}],"trial":[{"id":"eortc-40983","kind":"trial","name":"EORTC 40983","route":"/trials/eortc-40983/"},{"id":"paradigm","kind":"trial","name":"PARADIGM","route":"/trials/paradigm/"},{"id":"tribe","kind":"trial","name":"TRIBE","route":"/trials/tribe/"}]}}