How to treat liver metastases from colorectal cancer?

Due to the direct vascular connection between the bowel and liver, the liver is the most common site for the metastases of colorectal cancer (mCRC). Your doctors will evaluate how far the metastases have developed to decide among the different existing options which treatment will be the best for you.

Surgical techniques

Wherever possible, the standard of care for liver metastases from CRC is surgical resection.

This provides the only realistic possibility of providing a cure for liver tumours that have spread from the bowel.


Chemotherapy is used to shrink cancer which can help to control symptoms and may help people with advanced bowel cancer to live longer. Chemotherapy treatments may be provided alone or in combination with other cancer treatments

Standard chemotherapy regimens for mCRC include combinations of 5-fluorouracil/folinic acid (5-FU/FA) with irinotecan, oxaliplatin or both.

Chemotherapy for mCRC has three main aims:
• to reduce the size of unresectable metastases to potentially allow resection
• to reduce the risk of recurrence by treating undetectable micro-metastases
• to prevent or slow down tumour(s) growth, and reduce side effects of tumour growth (palliative)

Biological therapy

Some biological therapies stimulate or suppress the immune system to help the body fight cancer, infection, and other diseases. Other biological therapies attack specific cancer cells, which may help keep them from growing or kill them.

The main biological therapies used to treat mCRC are anti-EGFR therapies – drugs that limit growth and multiplication of cancer cells – and anti-angiogenic therapies (anti-VEGF) – drugs that limit the development of new blood vessel from the tumour.

These treatments are often given in combination with chemotherapy.

Selective Internal Radiation Therapy (SIRT)

SIRT is a special type of radiotherapy that targets liver tumours and delivers radiation from millions of tiny radioactive beads, called SIR-Spheres Y-90 resin microspheres, directly to the tumours.

The microspheres are injected through a catheter in the groin and travel through the arteries to lodge in the very small blood vessels in and around the liver tumours where they emit high doses of radiation. As the microspheres only give off radiation to a small area, they target the liver tumour while doing little damage to the surrounding healthy liver tissue.

In patients just diagnosed with non-operable liver metastases from colorectal cancer, the addition of SIR-Spheres Y-90 resin microspheres to standard chemotherapy can extend the time before tumours in the liver start to grow again.1

For more information on SIR-Spheres Y-90 resin microspheres and the technique, please visit this page.

For more information on clinical evidence with SIR-Spheres Y-90 resin microspheres in mCRC, please visit this page.


1. van Hazel GA et al. J Clin Oncol 2016; 34: 1723–31.


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