Liver Transplantation Compared to Chemotherapy in Patients With ColoRectal Cancer

This trial is studying whether a liver transplant might help people with colorectal cancer that has spread to the liver — a situation where standard surgery to remove the cancer is no longer possible — and comparing that approach to ongoing chemotherapy. **You may be eligible if...** - You have been diagnosed with colorectal cancer (cancer of the colon or rectum) that has spread to the liver - The liver tumors cannot be surgically removed - Scans show the cancer has not spread beyond the liver (small lung spots may be okay) - You are in reasonably good overall health and can handle daily activities - Your blood counts, liver function, and kidney function are within acceptable ranges - Your cancer has grown or you could not tolerate first-line chemotherapy **You may NOT be eligible if...** - You have lost more than 10% of your body weight in the last 6 months - Your BMI is over 30 - You have had surgery for cancer recurrence or spread to other organs within the last 1–2 years - The cancer has previously spread to your bones, brain, or lymph nodes outside the liver - You have had breast cancer or melanoma before - Your primary colon/rectal tumor has not been fully removed - You have a liver tumor larger than 10 cm - You have three specific high-risk factors at the time of enrollment (very high CEA blood marker, cancer diagnosed less than 2 years ago, and largest liver tumor over 5.5 cm) Talk to your doctor to see if this trial is right for you.