Trial Questions Role of Resection of the Primary Tumor in Metastatic Colorectal Cancer

For patients with unresectable metastatic colorectal cancer and an asymptomatic primary tumor, retrospective studies have suggested improved survival with resection of the primary cancer before chemotherapy. Prospective studies have suggested the feasibility of observation without primary tumor resection, with surgery reserved for use only as needed later in the course of treatment.

Investigators report results of JCOG 1007, a multicenter, open-label, phase 3 trial comparing chemotherapy alone (mFOLFOX6 or capecitabine oxaliplatin, plus bevacizumab) versus upfront surgery on the primary tumor followed by chemotherapy. Enrollment was closed early due to futility. Of 165 patients randomized, median age was 65, most had colonic primaries (93%) …