Loading
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.
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.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
530 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Progression-free survival (right-sided or RAS/BRAF mutant)primary | FOLFOXIRI plus bevacizumab | 144 | 10.6 months | 0.76 (0.6 to 0.98) | 0.032 | link |
| Doublet plus bevacizumab | 147 | 9 months | ||||
| Progression-free survival (left-sided, RAS and BRAF wild-type) | Doublet plus panitumumab | 116 | 10.4 months | 1.11 (0.84 to 1.48) | 0.46 | link |
| Doublet plus bevacizumab | 114 | 10.8 months |
Shares TRIBE, FOLFOXIRI (5-FU, leucovorin, oxaliplatin, irinotecan), FOLFIRI (5-FU, leucovorin, irinotecan), VEGF / VEGFR.
Shares PARADIGM, Sidedness (left vs right colon), FOLFIRI (5-FU, leucovorin, irinotecan), VEGF / VEGFR.
Shares EORTC 40983, Hepatectomy (liver resection), Oligometastatic disease, FOLFOX (5-FU, leucovorin, oxaliplatin).
Shares PARADIGM, Sidedness (left vs right colon), Panitumumab, BRAF.
Shares PARADIGM, Sidedness (left vs right colon), Panitumumab, FOLFIRI (5-FU, leucovorin, irinotecan).
Shares Sidedness (left vs right colon), FOLFIRI (5-FU, leucovorin, irinotecan), VEGF / VEGFR, FOLFOX (5-FU, leucovorin, oxaliplatin).
Shares Sidedness (left vs right colon), FOLFIRI (5-FU, leucovorin, irinotecan), VEGF / VEGFR, Anti-angiogenic therapy.
Shares PARADIGM, Sidedness (left vs right colon), VEGF / VEGFR, EGFR.