ESMO 17 th World Congress on Gastrointestinal Cancer, page-7

Wild
'Chatting to an oncology colleagues who attended ASCO, there remains some skepticism amongst some attendees regarding the clinical significance of the SIRFLOX findings given no oPFS benefit and the entrenched view that cancer is a systemic disease. Attitude seems to be to treat with chemo first and use SIRT if progression occurs. '

I'm not a specialist in cancer spread, so excuse me if my understanding is incorrect. My thought was that colon cancer hits the liver first, due to the blood supply, and then spreads to other organs.

If colon cancer can be caught very early then there is a much smaller chance of spreading to other organs. Once it spreads to the liver then the chances of spreading to other organs stats to go up, depending on the length of time in the liver.

Thus early resection of mCRC is the preferred option. One assumes that by the time resection is no longer an option there must be a much higher chance of addition organs being impacted.

At this point it now comes down to how best to manage the situation. If, and I think there is very open views, 90% of deaths are caused by the liver cancer then by extending the PFS in the liver it allows said additional time to manage the other organs.

I believe that death from cancer in the other organs can be extended by some years in most cases.

Thus I'm not understanding the view of the oncologists that you speak to. I would have thought that SIRT being used early to give the additional time to manage the other mets would be seen as a very good option.

I guess we find out in Feb when the 6 month dose sales are presented.