ERASur colorectal cancer trial reaches one-third patient accrual milestone

The ERASur (Evaluation of Resection or Ablation for Limited Metastatic Colorectal Cancer) clinical trial has reached a major enrollment milestone, with more than one-third of its targeted patients now accrued, signaling strong momentum for this national study.

ERASur (Alliance A022101) is investigating whether adding total ablative therapy—including ablative radiation, surgery, or thermal ablation of all metastatic sites—to standard chemotherapy can improve overall survival compared with chemotherapy alone in patients with newly diagnosed, limited metastatic colorectal cancer.

“This milestone reflects the commitment of patients, clinicians, and research teams across the country to answer a question that has major implications for how we treat metastatic colorectal cancer,” said Eric Miller, MD, PhD, principal investigator of the trial and associate professor of radiation oncology at The Ohio State University Comprehensive Cancer Center. “If successful, ERASur could help redefine the role of aggressive local therapy beyond liver-only metastases.”

Colorectal cancer is the third most common cancer diagnosed in both men and women in the United States with about 160,000 new cases per year, according to the American Cancer Society. Rates of diagnoses and deaths have dropped in recent decades due to advances in screening, like coloscopies and stool-based kits, that can identify precancerous lesions like polyps before they progress to cancer.

However, colorectal cancer is still the second leading cause of cancer-related deaths. There has also been a concerning rise in aggressive colorectal diagnoses among younger adults, underscoring the importance of studies like ERASur.

For patients whose colorectal cancer has spread only to the liver, local treatments such as surgery or ablative radiation are already known to improve outcomes. However, it’s unclear whether similar benefits extend to patients whose cancer has spread to up to four sites involving multiple organs. ERASur is designed to close this evidence gap.

The study is enrolling adults with newly diagnosed metastatic colorectal cancer limited to four or fewer sites of disease, as confirmed by imaging after four to 12 months of first-line chemotherapy. Participants are randomized to receive either chemotherapy alone or chemotherapy plus total ablative therapy targeting all remaining metastatic tumors.

“Accrual milestones like this are essential for advancing evidence-based cancer care,” said Dr. Miller. “Each patient enrolled brings us closer to answering whether a more aggressive local approach can meaningfully extend survival for this population. We are forever grateful to the families that trust us with their care.”

The growing momentum behind ERASur was recently highlighted at the Society of Surgical Oncology 2026 Annual Meeting in Phoenix. The presentation underscored the trial’s multidisciplinary approach and the clinical importance of rigorously evaluating aggressive local therapy for patients with limited metastatic colorectal cancer.

The trial is sponsored by National Cancer Institute (NCI), part of the National Institutes of Health, and is being led and conducted by NCI funded Alliance for Clinical Trials in Oncology with participation from the NCI-funded national clinical trials network (NCTN). It is currently enrolling patients at 183 locations across the U.S., including many community cancer centers through the Alliance’s NCTN participation, which brings clinical trials to the 90% of the country’s cancer patients that choose to receive treatments outside a major academic medical center.

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Reference: A022101: A Pragmatic Randomized Phase III Trial Evaluating Total Ablative Therapy for Patients with Limited Metastatic Colorectal Cancer: Evaluating Radiation, Ablation, and Surgery (ERASur)

The Alliance for Clinical Trials in Oncology is a national leader in advancing cancer research, uniting more than 25,000 cancer specialists at 115 main institutions and 1,400 affiliates across the U.S. and Canada. As part of the National Clinical Trials Network and a leading research base for the NCI Community Oncology Research Program, the Alliance conducts pioneering, practice-changing clinical trials that improve outcomes and reshape standards of care. Our work has led to multiple FDA approvals, influenced national guidelines, and produced hundreds of high-impact publications. More than 40,000 participants have taken part in Alliance studies, and our growing biospecimen repository now includes more than 1.5 million samples, collected over the past 30 years. Learn more at www.AllianceforClinicalTrialsinOncology.org.

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