Liver Transplantation for Non-resectable Colorectal Liver Metastases: Translational Research

Launched by HOSPITAL VALL D'HEBRON · May 25, 2022

Keywords

ClinConnect Summary

The METLIVER trial is studying the potential benefits of liver transplantation for patients with colorectal cancer that has spread to the liver but cannot be removed through surgery. These patients often face challenges with existing treatments, and the trial aims to understand the genetic characteristics of their tumors better. By analyzing the unique biology of these cancer cells, researchers hope to improve monitoring and develop targeted treatments that could help patients who experience a relapse, particularly those who may develop new metastases in the lungs after the transplantation.

To be eligible for this trial, participants must be between 18 and 70 years old with a confirmed diagnosis of colorectal cancer that has spread to the liver, and they must have undergone specific treatments prior to screening. They should not have any signs of cancer spread outside the liver and need to meet certain health criteria. Patients who join the trial can expect to contribute to important research that may lead to better outcomes for future patients while receiving care tailored to their individual needs.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Willing and able to provide written informed consent.
• • 2. Male or female, aged 18-70 years old inclusive at study entry.
• • 3. ECOG (Eastern Cooperative Oncology Group) 0 or 1.
• • 4. Histologically-proven primary colorectal tumor.
• • 5. Bilateral, limited at liver and non-resectable CRLM by consensus in Multidisciplinary Committee.
• • 6. Resection of primary colorectal tumor according oncological principles and adequate TNM stage.
• • 7. Time from primary colorectal tumor resection to transplant ≥ 12 months.
• • 8. Primary colorectal tumor stage ≤ T3N1. If time between primary tumor resection is ≥ 2 years, stage T4N0 or T4N2 is accepted.
• • 9. No signs of extrahepatic metastatic disease according to PET/CT scan, CT and pelvic MRI.
• • 10. The patient has undergone systemic chemotherapy for a minimum of 3 months at the time of screening and maximum of 2 lines of fluoropyrimidine based chemotherapy combined or not with irinotecan or oxaliplatin associated or no not with targeted therapy based in molecular biomarkers.
• • 11. Demonstrated stability or partial regression of CRLM following RECIST criteria v 1.1., at minimum 3 months since the last treatment received and immediately prior to screening.
• • 12. CEA (Carcinoembryonic antigen) values ≤ 80 µg/L immediately prior to screening.
• 13. Adequate blood test regarding:
• • Creatinine ≤1.25 x upper normal level or estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73m2 using following the Chronic Kidney disease epidemiology collaboration (CKD-EPI) formula.
• • Platelets ≥80 × 109/L
• • Neutrophiles ≥ 2.5 × 109/L
• • 14. Patients with hepatic failure after resection will be considered if it occurs as a consequence of an inadequate preoperative estimation of the functional volume that would have contraindicated the surgery. They should meet the inclusion criteria and none of the exclusion criteria.
• Exclusion Criteria:
• • 1. Largest Lesion \>5.5cm immediately prior to screening
• • 2. Patients with Lynch Syndrome
• • 3. BRAF mutation and/or primary tumor of microsatellite instability (MSI)
• • 4. Recurrence of primary tumor confirmed by colonoscopy or pelvic MRI within the last 12 months prior to screening.
• • 5. Previous or concurrent cancer in the last 5 years. Any cancer curatively treated 5 years prior to entry or treated basal cell carcinoma is permitted.
• • 6. Substance abuse, medical, psychological or social conditions that may interfere with the patient´s participation in the study or evaluation of the study results.
• • 7. Cardiac or pulmonary disease uncontrolled as contraindication for any surgical procedure.
• • 8. Active infection.
• • 9. Pregnant or breast-feeding patients
• • 10. Any reason why in the opinion of the investigator, the patient should not participate.