Another pseudoadjuvant situation we inquired about focuses on the patient who requires preoperative systemic treatment to shrink the tumor to facilitate a resection. Perhaps fearing the even higher likelihood of recurrence associated with this so-called conversion approach, GOs are more likely to use postoperative biologic therapy than they would be when the tumor is initially operable. Interestingly, both faculty members would stick with the same approach employed in those types of cases — short-term chemotherapy without a biologic.

Allegra CJ et al. Phase III trial assessing bevacizumab in stages II and III carcinoma of the colon: Results of NSABP protocol C-08. J Clin Oncol 2011;29(1):11-6. Abstract

Fernandez FG et al. Effect of steatohepatitis associated with irinotecan or oxaliplatin pretreatment on resectability of hepatic colorectal metastases. J Am Coll Surg 2005;200(6):845-53. Abstract

Primrose J et al. Systemic chemotherapy with or without cetuximab in patients with resectable colorectal liver metastasis: The New EPOC randomised controlled trial. Lancet Oncol 2014;15(6):601-11. Abstract