EPA for Metastasis Trial 2

Prior treatment

• Previous CRCLM surgery for the management of the current metastatic disease
• Current (in the last 2 months) or planned regular (\>3 doses per week) use of O3FA-containing drugs or supplements, including Vazkepa®, Omacor®, fish oil and cod-liver oil supplements

Other illness

• Fish/seafood allergy
• Soya or peanut allergy
• Known bleeding tendency/condition (e.g. von Willebrand disease)
• A previous malignancy within the last 5 years other than:
  • colorectal cancer
  • non-melanoma skin cancer where treatment consisted of resection only or radiotherapy
  • ductal carcinoma in situ (DCIS) where treatment consisted of resection only
  • cervical carcinoma in situ where treatment consisted of resection only
  • superficial bladder carcinoma where treatment consisted of resection only

Age

• A previous malignancy where the patient has been disease free for ≤ 5 years

Other

• Incurable extra-hepatic metastases
• Diagnosis of hereditary fructose intolerance
• Inability to comply with trial treatment and follow-up schedule
• Pregnant or breastfeeding women or women of childbearing potential not willing to use effective contraceptive measures. Women of childbearing potential are defined as fertile, following menarche and until becoming post-menopausal, unless permanently sterile
• Men defined as fertile (post-pubescent and not permanently sterile by vasectomy or bilateral orchidectomy) and not willing to use effective contraceptive measures if appropriate.

• Aged ≥ 18 years
• Able to provide written informed consent
• Histological diagnosis of colorectal cancer with evidence of liver metastases
• Planned liver resection surgery for colorectal cancer liver metastases with curative intent, including repeat 're-do' colorectal cancer liver metastases surgery (a second independent resection for a separate colorectal cancer liver recurrence)
• Intention to receive IMP prior to colorectal cancer liver metastases surgery