Recurrent Colorectal Liver Metastases: Upfront Local Treatment versus Neoadjuvant Systemic Therapy Followed by Local Treatment (COLLISION RELAPSE): Study Protocol of a Phase III Prospective Randomized Controlled Trial

Cardiovasc Intervent Radiol. 2024 Feb;47(2):253-262. doi: 10.1007/s00270-023-03602-y. Epub 2023 Nov 9.

Abstract

Purpose: The objective of the COLLISION RELAPSE trial is to prove or disprove superiority of neoadjuvant systemic therapy followed by repeat local treatment (either thermal ablation and/or surgical resection), compared to repeat local treatment alone, in patients with at least one recurrent locally treatable CRLM within one year and no extrahepatic disease.

Methods: A total of 360 patients will be included in this phase III, multicentre randomized controlled trial. The primary endpoint is overall survival. Secondary endpoints are distant progression-free survival, local tumour progression-free survival analysed per patient and per tumour, systemic therapy-related toxicity, procedural morbidity and mortality, length of hospital stay, pain assessment and quality of life, cost-effectiveness ratio and quality-adjusted life years.

Discussion: If the addition of neoadjuvant systemic therapy to repeat local treatment of CRLM proves to be superior compared to repeat local treatment alone, this may lead to a prolonged life expectancy and increased disease-free survival at the cost of possible systemic therapy-related side effects.

Level of evidence: Level 1, phase III randomized controlled trial.

Trial registration: NCT05861505. May 17, 2023.

Keywords: Colorectal cancer; Colorectal liver metastases (CRLM); Neoadjuvant systemic therapy; Randomized controlled trial (RCT); Surgery; Thermal ablation.

Publication types

  • Clinical Trial Protocol

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Clinical Trials, Phase III as Topic
  • Colorectal Neoplasms* / pathology
  • Humans
  • Liver Neoplasms* / surgery
  • Multicenter Studies as Topic
  • Neoadjuvant Therapy
  • Prospective Studies
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Recurrence

Associated data

  • ClinicalTrials.gov/NCT05861505