Key clinical point: Primary tumor resection (PTR) of asymptomatic tumor followed by systemic therapy is associated with a significantly higher 60-day mortality than systemic therapy alone in patients with nonresectable metastatic colorectal cancer (mCRC).
Major finding: Deaths within 60 days of randomization were significantly higher in the PTR vs systemic therapy alone (11% vs 3%; P = .03) arm with elevated levels of lactate dehydrogenase ( P = .046), neutrophils ( P = .04), aspartate aminotransferase ( P < .001), and alanine aminotransferase ( P = .002) being associated with higher 60-day mortality in the PTR arm.
Study details: CAIRO4 is a randomized phase 3 trial including 198 patients with nonresectable mCRC and asymptomatic primary tumor randomly assigned to systemic therapy alone or PTR followed by systemic therapy with palliative intent.
Disclosures: The study was funded by Dutch Cancer Society and Hoffmann-La Roche. Dr. DEW van der Kruijssen, Dr. GR Vink, Dr. JHW de Wilt, and Dr. M Koopman reported receiving grants and/or nonfinancial support from various sources including Hoffmann-La Roche Ltd.
Source: van der Kruijssen DEW et al. JAMA Surg. 2021 Oct 6. doi: 10.1001/jamasurg.2021.4992 .