Thanks TP, Existing first line data from those small trials...

Thanks TP, Existing first line data from those small trials suggests OS of about 30 months for SIRT, vs 16-20 months for FOLFOX4. 3 months would seems quite achievable.

To understand the likely impact of controlling liver disease on OS, some guidance could be given from trials where unresectable disease was converted to complete liver met resection (R0). In the study below of unresectable liver met patients with FOLFOX/FOLFIRI + cetuximab the PFS was about 10 months (similar to SIRFLOX). Patients converted to R0 liver met resection had median OS of 53.9 months, vs 21.9 months in those still unable to be resected. Median disease free survival in R0 group was 9.9 months (again, similar to overall PFS in SIRFLOX), with 46% 5 year survival. Halting the disease by SIRT is unlikely to have the same degree of impact on OS as resection, but extra hepatic disease seemed to have limited impact on OS in the R0 group. Would be interested in any other relevant trials.

I am confident that this SIRFLOX result will translate to a clinically meaningful impact (but please DYOR). One possible issue is whether competing technologies that could enable similar local control (e.g. radio frequency ablation), or whether these could be used in combination with SIRT. Happy weekend to all holders!

http://annonc.oxfordjournals.org/content/25/5/1018.long