The addition of selective internal radiation therapy (SIRT) to FOLFOX-based first-line chemotherapy in patients with liver-dominant or liver-only metastatic colorectal cancer (mCRC) did not improve progression-free survival (PFS) at any site but significantly delayed disease progression in the liver. This according to a study of 530 patients with previously untreated mCRC. Researchers found:

• Median PFS at any site was 10.2 months in controls vs 10.7 in SIRT.

• Median PFS in the liver by competing risk analysis was 12.6 months in controls vs 20.5 months in SIRT.

• Objective response rates (ORR) at any site were similar in control vs SIRT.

• ORR in the liver was improved with SIRT added (68.8% vs 78.7% controls vs SIRT).

• Grade ≥ 3 adverse events, including recognized SIRT-related effects, were reported in 73.4% of controls and 85.4% of SIRT.

Citation: van Hazel GA, Heinemann V, Sharma NK, et al. SIRFLOX: Randomized phase III trial comparing first-line mFOLFOX6 (plus or minus bevacizumab) versus mFOLFOX6 (plus or minus bevacizumab) plus selective internal radiation therapy in patients with metastatic colorectal cancer. [Published online ahead of print February 22, 2016]. Clin Oncol. doi: 10.1200/JCO.2015.66.1181.