Interdisciplinary patient-centred care with quality control within palliative therapy of colorectal carcinoma (IVOPAK II) A Treatment path based on the Guidelines- Personalized therapy of colorectal cancer (CRC) with region-wide controll supply -

Interventions: Group 1: We test if the patients have an all-RAS wild-type or a mutation. On the basis of the pathological molecular biological determination we find out if there exists a K-RAS and N-RAS (All-RAS)-wildtype or a mutation of the patient s tumour. If all-RAS-wildtype is determined, an anti-EGFR-therapy e. g. with cetuximab plus chemotherapy e. g. FOLFIRI-regimen, according to the current guidelines is initiated. If a mutation is determined, an anti-VEGFR-therapy with bevacizumab plus chemotherapy first-line is initiated.
Group 2: On the basis of the pathological-molecular biological determination (by a certificated pathological institute) a systemic therapy with a combined chemotherapy with irinotecan (FOLFIRI) or a combined chemotherapy with oxaliplatin (FOLFOX4) plus bevacizumab is initiated if a mutation of K-RAS (exon 2, 3, 4) or N-RAS (exon 2, 3, 4) in the tumour tissue is determined and the imaging clinical monitoring is presented bi-monthly (continous-check-strategy) in the interdisciplinary tumour-board, performing a secondary metastatic resection after downsizing of first- or second-line therapy. The prognosis of the palliative patients should be improved and a curative option should be achieved by interdisciplinary collaboration (conversion).
Primary outcome(s): implementation of the interdisciplinary tumour board recommandations
Study Design: Allocation: ; Masking: ; Control: ; Assignment: ; Study design purpose: treatment