ERASur: What does participating involve for me?
If you decide to take part in this study, you will receive intravenous and/or oral drugs (chemotherapy, biological therapy at the discretion of your treatment team) for 4-6 months, and then you will be randomized to either receive total ablative therapy (TAT) or continue with systemic therapy alone as shown in the schema below.
We want to treat all visible sites after induction chemo with TAT.
One of the eligibility criteria upfront is that all sites are amenable to TAT, so if they weren’t for some reason prior to starting chemo, then they wouldn’t be eligible for the trial.
If patients progress during treatment, then they would also not continue with randomization.
Trial schema
Treatment details
If you are randomized to the TAT group, you will receive ablative local therapy to all sites of disease seen on your most recent radiographic imaging. TAT will consist of ablative radiation therapy to at least one site with or without surgical resection and/or heat with microwave ablation. The combination of TAT to be used to treat all of your metastatic sites will be decided by you and your doctor. If your primary tumor has not yet been surgically removed, it will also be removed for patients in the TAT group.
If you are randomized to the systemic therapy group, you will receive the usual systemic drug therapy used to treat metastatic colorectal cancer at the discretion of your treatment team. You may also receive palliative local therapies to metastatic sites such as surgery or radiation to help relieve uncontrolled symptoms caused by your cancer.
Following treatment in either group, you will undergo repeat physical examination, blood tests, and restaging imaging every 3 months until disease progression or up to 5 years.