A Pragmatic Randomized Phase III Trial Evaluating Total Ablative Therapy for Patients with Limited Metastatic Colorectal Cancer: Evaluating Radiation, Ablation, and Surgery (ERASur)

For patients with your stage of metastatic colorectal cancer, ablative local therapy (ALT) is commonly used to treat all known tumor sites. ALT may be performed by surgery, radiation therapy, heat with microwave ablation, or other methods. This study will use radiation therapy and potentially surgery and/or heat. The use of ALT in addition to your usual treatment could shrink your cancer and prevent it from returning. Although it is common to use ALT, at this time, it is not scientifically proven that the addition of ALT is beneficial for your stage of cancer. The purpose of this study is to determine if adding ALT to the usual approach of systemic therapy for treatment of your metastatic colorectal cancer can lengthen your survival.

Are you Eligible? (Inclusion Criteria)

• To be considered for this study, subjects must: 1. Histologically-confirmed metastatic colorectal adenocarcinoma 2. Primary tumor is already resected OR primary tumor is surgically amenable to resection. Patients with unresectable primary tumors are not eligible.. 3. Be 18 years of age or older 4. Four or fewer apparent sites of metastatic disease based on review by local medical team of baseline radiographic imaging obtained prior to initiation of systemic therapy 5. Patients must be receiving (or have received) first-line systemic therapy for metastatic disease for a minimum of 16 weeks (4 months) and a maximum of 24 weeks (6 months).