Unresectable liver metastases from colorectal cancer remain a major challenge in oncology, despite advances in treatment. In the face of this problem, chemotherapy-associated liver transplantation has been proposed as a new therapeutic approach.
The primary objective of the European multicenter TransMet study was to determine whether liver transplantation, combined with chemotherapy, significantly improved overall survival for patients with unresectable liver metastases from colorectal cancer, compared With chemotherapy alone.
The TransMet study, conducted at 20 centers in Europe, included 94 patients aged 18 to 65 years with exclusively liver metastases, unresectable and well controlled with at least three months of chemotherapy and a maximum of three lines of treatment. Participants in this study were randomly divided into two groups: the first to receive a liver transplant followed by chemotherapy and the second to receive chemotherapy only. The initial evaluation was five-year overall survival.
In the 74 patients who had already received the prespecified treatment, results showed a significant improvement in overall survival in the group receiving a transplant, with a five-year survival rate of 73% compared to 9% in the group that did not. Transplantation. The rate of serious complications was similar between the two groups. After a median follow-up of 50 months, 42% of patients were in complete remission after transplantation compared with only 3% after chemotherapy alone.
The TransMet study demonstrates that liver transplantation, combined with chemotherapy, provides a significant improvement in survival for patients with unresectable liver metastases from colorectal cancer. This strategy is potentially therapeutic. These findings justify a re-evaluation of current clinical recommendations in oncology.
