To evaluate the efficacy and safety of raltitrexed-eluting microspheres for transarterial chemoembolization (TACE) combined with systemic therapy in patients with advanced colorectal cancer with liver metastases.

Fifty patients with newly diagnosed, potentially resectable colorectal cancer with liver metastases were enrolled and randomly assigned to an experimental group (n=25) or a control group (n=25). The experimental group received systemic therapy (chemotherapy plus targeted drugs) combined with TACE using raltitrexed-eluting microspheres (CalliSpheres). The control group received systemic therapy alone (chemotherapy plus targeted drugs). Short-term efficacy, surgical resection conversion rates, and adverse events were compared between groups.

In the experimental group, the complete response (CR) rate was 8%, partial response (PR) rate 60%, stable disease (SD) rate 24%, progressive disease (PD) rate 8%, objective response rate (ORR) 68%, and disease control rate (DCR) 92%. In the control group, the CR rate was 4%, PR 36%, SD 20%, PD 40%, ORR 40%, and DCR 60%. The experimental group had significantly higher ORR and DCR (P<0.05). Surgical resection conversion rates were 40% in the experimental group and 8% in the control group (P<0.05). Adverse events, including elevated transaminases, leukopenia, neutropenia, anemia, thrombocytopenia, hyperbilirubinemia, nausea, vomiting, and elevated creatinine, showed no significant difference between groups (P>0.05). The experimental group had significantly higher 2-year overall survival (OS) and progression-free survival (PFS) at 3, 6, and 12 months compared to the control group (P<0.05).

In patients with advanced colorectal cancer with liver metastases, TACE using raltitrexed-eluting microspheres combined with systemic therapy significantly improves clinical efficacy, surgical resection conversion rates, 2-year OS, and short-term PFS without increasing adverse events compared to systemic therapy alone. This approach warrants broader clinical adoption.