How to select the optimal treatment for first line metastatic colorectal cancer

Table 2 European Society for Medical Oncology clinical groups for first line treatment stratification[10]

ESMO group	Clinical presentation	Treatment aim	Treatment intensity
0	Clearly R0-resectable liver and/or lung metastases	Decrease risk of or delay relapse	FOLFOX
1	Liver and/or lung metastases only which:Might become resectable after induction chemotherapy	Maximum tumour shrinkage	Three or four drug combination
2	Multiple metastases/sites, with:Rapid progression and/orTumour-related symptoms/risk of rapid deterioration	Immediate clinically relevant response or at least tumour control	Three or four drug combination
3	Multiple metastases/sites without option for resection and no major symptoms or severe comorbidity	Abrogation of further progressionTumour shrinkage less relevantLow toxicity essential	Consider sequential approach: start withSingle agent, orDoublet with low toxicity

ESMO: European Society for Medical Oncology.