Conversion Therapy of RAS/BRAF Wild-Type Right-sided Colon Cancer Patients With Initially Unresectable Liver Metastases
Conversion Therapy of RAS/BRAF Wild-Type Right-sided Colon Cancer Patients With Initially Unresectable Liver Metastases
The prognosis of patients with metastatic right-sided colon cancer is worse than that of
 patients with metastatic left-sided cancer. Different guidelines have different
 recommendations on specific conversion therapy for colorectal liver metastases. The United
 States NCCN guidelines do not recommend standard chemotherapy combined with anti EGFR
 monoclonal antibody for patients with right colon cancer. The European ESMO guidelines
 recommend that patients with Ras / BRAF wild-type right-sided colon cancer should first
 consider three drugs ± bevacizumab, but considering the objective response rate results,
 standard chemotherapy + anti EGFR monoclonal antibody is still one of the choices. China CSCO
 guidelines recommend standard chemotherapy ± bevacizumab, and also recommend standard
 chemotherapy + cetuximab for patients with right-sided colon cancer.

 Therefore, the targeted therapy for RAS / BRAF wild-type metastatic right colon cancer is
 still controversial. Therefore, we are ready to carry out the clinical trial of cetuximab and
 bevacizumab in conversion therapy for RAS / BRAF wild-type metastatic right colon cancer. The
 conversion resection rate is the primary point, and the objective response rate,
 perioperative safety and long-term survival are the secondary points.
Inclusion Criteria:

 1. The primary tumor was confirmed by histology as colorectal adenocarcinoma

 2. primary right-sided colorectal adenocarcinoma

 3. Radiologic evidence suggests that the initial unresectable liver metastases

 4. RAS/BRAF gene wild-type states

 5. ECOG was 0 ~ 1

 6. Life expectancy ≥ 3 months

 7. Good hematological function: neutrophil ≥ 1.5x109/l and platelet count ≥ 100x109 / L;
 HB ≥ 9g / dl (within one week before randomization)

 8. Normal liver and kidney function: serum bilirubin ≤ 1.5x normal upper limit (ULN),
 alkaline phosphatase ≤ 5x ULN, serum transaminase (AST or ALT) ≤ 5x ULN (within one
 week before randomization);

 9. Sign the written informed consent to participate in the experiment

 Exclusion Criteria:

 1. Patients with liver metastases from colorectal cancer who have previously received
 targeted therapy, chemotherapy, radiotherapy or interventional therapy

 2. Known or suspected extrahepatic metastasis

 3. Patients with known hypersensitivity to any component of the study treatment

 4. Clinical related coronary heart disease or history of myocardial infarction in the
 last 12 months or left ventricular ejection fraction below normal range

 5. Acute or subacute intestinal obstruction

 6. Pregnancy (no pregnancy confirmed by serum / urine β - hCG) or breastfeeding.

 7. She had other malignant tumors within 5 years, except for those with skin basal cell
 carcinoma or cervical cancer

 8. Known drug / alcohol abuse

 9. No legal capacity or limited legal capacity

 10. There is peripheral neuropathy