Evidence-based medical oncology and interventional radiology paradigms for liver-dominant colorectal cancer metastases

Abstract

Colorectal cancer metastasizes predictably, with liver predominance in most cases. Because liver involvement has been shown to be a major determinant of survival in this population, liver-directed therapies are increasingly considered even in cases where there is (limited) extrahepatic disease. Unfortunately, these patients carry a known risk of recurrence in the liver regardless of initial therapy choice. Therefore, there is a demand for minimally invasive, non-surgical, personalized cancer treatments to preserve quality of life in the induction, consolidation, and maintenance phases of cancer therapy. This report aims to review evidence-based conceptual, pharmacological, and technological paradigm shifts in parenteral and percutaneous treatment strategies as well as forthcoming evidence regarding next-generation systemic, locoregional, and local treatment approaches for this patient population.

Keywords: Antineoplastic agents; Chemoembolization; Colonic neoplasms; FOLFOX protocol; Immunotherapy; Irinotecan, 5-flurouracil, and leucovorin protocol; Microwave ablation; Neoplasm metastasis; Radiofrequency ablation; Rectal neoplasms; Therapeutic.