Personalized Treatment Selection with Oncogramme® Device for Metastatic Colorectal Cancer

Study start date: June 7, 2023

Inclusion Criteria: * 18 years old and older * Patient with suspected mCRC (synchronous or metachronous metastases (only if biopsy is required as part of routine care)) * Patient eligible for standard systemic chemotherapy (multidrug therapy such as FOLFOX, FOLFIRI, FOLFIRINOX, combined or not with anti- EGFR or anti-VEGF targeted therapies adapted to BRAF and RAS expression) * colorectal adenocarcinoma histologically proven * At least one measurable metastasis according to RECIST v1.1 * Chemotherapy for curative or palliative purposes * Oncograms® can be performed * WHO score ≤ 2 * Life expectancy \> 3 months * neutrophils \> 1500/mm3, platelets \> 100 000/mm3, Hb \> 9 g/dL * Total bilirubin \< 25 μmol/L, aspartate aminotransferase \< 5 ULN (upper limits of normal), alanine aminotransferase \< 5 ULN, alkaline phosphatase \< 5 ULN, prothrombin rate \> 60%, proteinuria \< 1 g/24h * No prior chemotherapy except peri-operative or adjuvant chemotherapy stopped more than 6 months ago * Creatinine clearance \> 50 mL/min according to MDRD formula * Patient affiliated to a social security scheme * Information to the patient and signature of the informed consent form. Exclusion Criteria: * Patients eligible for curative treatment (surgical and/or percutaneous) after discussion in multidisciplinary consultation meeting (isolated class I liver metastases) * Patients with metachronous metastases not requiring biopsy as part of their standard management. * Myocardial infarction, severe/unstable angina, coronary artery bypass grafting, New York Heart Association (NYHA) class II, III, or IV congestive heart failure, stroke, or transient ischemic attack within 6 months prior to inclusion * HTA not controlled by medical treatment (systolic blood pressure \> 140 mmHg and/or diastolic blood pressure \> 90 mmHg) * History of abdominal fistula, gastrointestinal perforation, intra-abdominal abscess or active gastrointestinal bleeding in the 6 months preceding the start of treatment * Active peptic ulcer * Deep wound or bone fracture not resolved within 3 months * Major abdominal or extra-abdominal surgical procedure (except diagnostic biopsy or implantable site placement) * Irradiation within 4 weeks prior to the start of treatment * Transplant patients, HIV-positive, or other immunodeficiency syndromes * Previous chemotherapy (except peri-operative or adjuvant chemotherapy discontinued more than 6 months ago) * Any progressive disease not balanced during the last 6 months: hepatic insufficiency, renal insufficiency, respiratory insufficiency * Peripheral neuropathy \> 1 (CTCAE Common terminology criteria for adverse eventsv5.0) * Patient with interstitial lung disease or pulmonary fibrosis * History of chronic diarrhea or inflammatory disease of the colon or rectum, or occlusion or sub-occlusion unresolved with symptomatic treatment * History of malignancy within the last 5 years except for properly treated non-metastatic colon cancer, basal cell skin carcinoma or carcinoma in situ of the uterine cervix * Patient already included in another therapeutic trial with an investigational treatment or who has been out of a trial for less than 6 months * Any specific contraindication or known allergy to the drugs used in the study. * Known dihydropyrimidine dehydrogenase deficiency * QT/QTc interval \> 450 ms for men and \> 470 ms for women * Kalemia (K+) \< LIN (lower limit to normal), magnesemia (Mg2+)\< LIN, calcemia (Ca2+)\< LIN * Lack of effective contraception (at least 2 different means) in patients (male or/and female) of childbearing age, or for females, 12 months of confirmed amenorrhea, pregnant or lactating woman, woman of childbearing age who has not performed a pregnancy test (serum test) * Persons deprived of liberty or under guardianship * Impossible to undergo the medical follow-up of the trial for geographical, social or psychological reasons.