Regional Therapies for Colorectal Cancer Liver Metastases

Guideline Objective:

To make recommendations regarding regional therapies for adults with resectable or unresectable liver metastases from colorectal cancer (CRC) with an emphasis on overall survival, progression-free survival, time to progression, time to hepatic progression, overall response rate, and toxicity.

Patient Population:

These recommendations apply to adults with resectable or unresectable liver metastases from CRC.

Intended Guideline Users:

The intended users of this guideline are clinicians involved in the delivery of care to patients with liver metastases from CRC.

Research Questions:

This guidance document examined the evidence to answer the following questions:

1. What is the benefit of the addition of cTACE to systemic therapy in those with resectable CRC liver metastases?
2. What is the benefit of the addition of DEB-TACE to systemic therapy in those with resectable CRC liver metastases?
3. What is the benefit of the addition of TARE to systemic therapy in those with resectable CRC liver metastases?
4. What is the benefit of the addition of cTACE to systemic therapy in first-line treatment of those with unresectable CRC liver metastases?
5. What is the benefit of the addition of DEB-TACE to systemic therapy in first-line treatment of those with unresectable CRC liver metastases?
6. What is the benefit of the addition of TARE to systemic therapy in first-line treatment of those with unresectable CRC liver metastases?
7. What is the benefit of cTACE with or without systemic therapy in second-line (or later) treatment of those with unresectable CRC liver metastases?
8. What is the benefit of DEB-TACE with or without systemic therapy in second-line (or later) treatment of those with unresectable CRC liver metastases?
9. What is the benefit of TARE with or without systemic therapy in second-line (or later) treatment of those with unresectable CRC liver metastases?