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Neoadjuvant Chemotherapy for Resectable Colorectal Cancer Liver Metastases: Indications and Results

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Colorectal Cancer Liver Metastases

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Abstract

The role of neoadjuvant chemotherapy (NACT) in resectable colorectal liver metastases (CRLM) is controversial but has nevertheless become standard of care in some centres. The debate is whether the potential benefit for NACT in CRLM is adjuvant or a downsizing effect and consequently how best to measure this: should the endpoint of studies be survival or response and operability? To date a benefit in progression-free survival but not overall survival has been demonstrated in randomised controlled trials. There remain unanswered questions regarding patient selection, scheduling and treatment regimen. There are no accepted predictive biomarkers to guide personalisation of therapy, and patient selection is based upon prognostic rather than predictive criteria. In this chapter we review the evidence for and against NACT, explore the role of biological therapies and provide a summary of current international guidelines.

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Authors and Affiliations

  1. University College London Hospital NHS Trust, London, UK

    Anna Ryan & John Bridgewater

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  1. Anna Ryan
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  2. John Bridgewater
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Correspondence to John Bridgewater .

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Editors and Affiliations

  1. National Cancer Institute, Rio de Janeiro, Brazil

    Mauro Monteiro Correia

  2. Banner MD Anderson Cancer Center, Phoenix, AZ, USA

    Michael A. Choti

  3. Virginia Mason Medical Center, Seattle, WA, USA

    Flavio G. Rocha

  4. Center for Advanced Treatment of HBP Diseases, Ageo Central General Hospital, Ageo Shi, Saitama, Japan

    Go Wakabayashi

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Ryan, A., Bridgewater, J. (2020). Neoadjuvant Chemotherapy for Resectable Colorectal Cancer Liver Metastases: Indications and Results. In: Correia, M., Choti, M., Rocha, F., Wakabayashi, G. (eds) Colorectal Cancer Liver Metastases. Springer, Cham. https://doi.org/10.1007/978-3-030-25486-5_16

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  • DOI: https://doi.org/10.1007/978-3-030-25486-5_16

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