Treatment of Stage IV and Recurrent Colon Cancer

local excision for tumors that have recurred

resection with or without anastomosis

surgery to remove parts of other organs, such as the liver, lungs, and ovaries, where the cancer may have recurred or spread

radiation therapy or chemotherapy, as palliative therapy to relieve symptoms and improve quality of life

chemotherapy with or without targeted therapy (bevacizumab, cetuximab, fruquintinib, panitumumab, ramucirumab, or regorafenib, or ziv-aflibercept)

targeted therapy with encorafenib and cetuximab in patients with a certain change in the BRAF gene

immunotherapy (nivolumab or pembrolizumab, or nivolumab and ipilimumab combined)

chemotherapy given before surgery to shrink the tumor, after surgery, or both before and after

radiofrequency ablation or cryosurgery, for patients who cannot have surgery

chemoembolization of the hepatic artery

liver transplant after chemotherapy for patients with liver metastases that cannot be removed by surgery