Objective:

To compare the therapeutic efficacy and safety of FOLFOXIRI triplet chemotherapy with FOLFIRI combined with hepatic arterial infusion chemotherapy (HAIC) in patients with unresectable colorectal liver metastases.

Approach:

Key Findings:

• FOLFIRI plus HAIC group had a higher ORR (56.9% vs. 44.8%, p = 0.163) and DCR (89.2% vs. 68.7%, p = 0.004) compared to FOLFOXIRI group.
• Significantly longer PFS in FOLFIRI plus HAIC group (10.3 months vs. 8.2 months, log-rank p = 0.038).
• Median OS was numerically longer in FOLFIRI plus HAIC group (19.5 months vs. 17.9 months), but not statistically significant (log-rank p = 0.150).
• Higher R0 resection rate in FOLFIRI plus HAIC group (21.5% vs. 9.0%, p = 0.044).
• Grade 3/4 adverse events were comparable between groups (30.8% vs. 38.8%, p = 0.333).

Interpretation:

FOLFIRI plus HAIC was associated with improved disease control and prolonged PFS compared to FOLFOXIRI.

Limitations:

• Retrospective and non-randomized design.
• Findings should be interpreted cautiously and validated in prospective randomized studies.

Conclusion:

FOLFIRI plus HAIC demonstrated superior outcomes in disease control and PFS compared to FOLFOXIRI in patients with unresectable liver metastases.

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