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Systemic chemotherapy has improved survival in metastatic colorectal cancer. However, a substantial minority of patients have liver-predominant metastases. Whether liver-directed therapy should be part of the treatment strategy is the subject of ongoing debate. Now, investigators have conducted an industry-sponsored, multicenter, randomized phase III trial (SIRFLOX) to determine the potential benefit of adding liver-directed selective internal radiation therapy (SIRT) in previously untreated patients with liver-predominant metastatic disease.
A total of 530 patients were randomized to receive mFOLFOX6 (modified fluorouracil, leucovorin, and oxaliplatin) alone or sequenced with SIRT using yttrium-90 resin microspheres delivered by intrahepati…