The Excalibur-project explores new treatment options for patients with colorectal liver metastases and heavy tumour burden with insufficient response to systemic chemotherapy.
Standard of care for these patients today is next line systemic chemotherapy. In the Excalibur-project we are studying a potential benefit of adding two experimental modalities: liver transplant (Liver TX) and hepatic artery infusion (HAI) of the chemotherapeutic drug Floxuridine (FUDR) to conventional systemic chemotherapy.
While already established as a valuable treatment option for highly selected patients, liver TX has not been tested in patients with insufficient response to systemic chemotherapy at the time of inclusion.
HAI/FUDR is established in both the adjuvant and neoadjuvant setting in the US through the pioneering work at Memorial Sloan Kettering Cancer Center, New York. Until 2023, randomised trials in a neoadjuvant setting had not been performed, but a multicentre trial is planned to recruit from August 2023 also in the USA. This protocol closely resembles Excalibur 2. A randomised trial testing HAI/FUDR as an adjuvant following liver resection is presently running in The Netherlands
Aiming to establish better treatment options for these patients with a dismal prognosis the study-group, led by Dr Kristoffer Lassen and Dr Svein Dueland, designed the EXCALIBUR-trial and started inclusion in September 2021, sponsored by Oslo University Hospital and South-Eastern Regional Health Authority (Helse Sør-Øst RHF). We strongly acknowledge the support and mentoring from Erasmus Medical Centre Rotterdam in setting up the HAI/FUDR program.
Based at Oslo University Hospital (Rikshospitalet) the EXCALIBUR-trial is open for patients nationwide.
We sincerely hope our research will support the development of better treatment options for patients with colorectal liver metastases and heavy tumour burden.
On behalf of the study group
Anne Longva, Marie Lian, Tor Magnus Smedman, Sheraz Yaqub, Bård Røsok, Åsmund Fretland, Kristoffer Brudvik, Olaug Villanger, John Christian Glent, Svein Dueland, Pål-Dag Line and Kristoffer Lassen