COLLISION RELAPSE Trial

Inclusion criteria * Age \>18 years * Good performance status (ECOG 0-2 // ASA 1-3) * Histological documentation of primary colorectal tumor * Local treatment performed for initial CRLM * New recurrence ≤12 months * ≥1 locally treatable CRLM (resectable\* and/or ablatable) * Total number of new CRLM ≤5 * Chemo-naïve or history of response to CAPOX/FOLFOX/FOLRIRI * Life expectancy of at least 12 weeks * Adequate bone marrow, liver and renal function * Written informed consent Exclusion criteria * Extrahepatic disease * MSI/dMMR * Radical local treatment unfeasible or unsafe (e.g. insufficient future liver volume) * Compromised liver function (e.g. signs of portal hypertension, INR \> 1,5 without use of anticoagulants, ascites) * Uncontrolled infections (\> grade 2 NCI-CTC version 3.0) * Pregnant or breast-feeding subjects * Immuno- or chemotherapy ≤ 6 weeks prior to the randomization * Severe allergy to contrast media not controlled with premedication * Substance abuse, medical, psychological or social conditions that may interfere with the subject's participation in the study or evaluation of the study results ECOG = Eastern Cooperative Oncology Group, ASA = American Society of Anesthesiologists, MSI = Microsatellite instability, dMMR = deficient mismatch repair \* Resection for resectable lesions considered possible obtaining negative resection margins (R0) and preserving adequate liver reserve