ArticleESMO gastrointestinal oncology2025
Preoperative immunotherapy with atezolizumab and tiragolumab in patients with colorectal liver metastases-the PURPLE trial.
Article in ESMO gastrointestinal oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- Colorectal cancer liver metastasis: immunosuppressive microenvironment, signaling pathways, and emerging therapeutic strategies.Frontiers in immunology · 2026Review
- Beyond mismatch repair in colorectal cancer liver metastases: rethinking immunotherapy through the hepatic metastatic niche.Frontiers in immunology · 2026Article
- Multicellular immunosuppressive networks in microsatellite-stable colorectal cancer: CD8+ T cell exclusion, dysfunction, exhaustion, and therapeutic implications.Frontiers in immunology · 2026Review
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: In colorectal cancer (CRC), the liver is the most common site of metastasis, which is the leading cause of CRC-related mortality. Hepatic resection offers long-term survival in some patients with CRC liver metastases (CRLM), but recurrence rates remain high (50%-75% within 2 years). Preoperative immunotherapy may induce tumor regression and improve long-term surgical outcomes. The PURPLE trial evaluates the feasibility, safety, and efficacy of short-term preoperative immunotherapy with the anti-programmed death-ligand 1 (PD-L1) antibody atezolizumab and the anti-T cell immunoreceptor with Ig and ITIM domains (TIGIT) antibody tiragolumab in patients with resectable CRLM. Study design: PURPLE is an international, open-label, multicenter, randomized phase II 'window of opportunity' trial. Patients with resectable CRLM are randomized 2 : 1 to receive two cycles of atezolizumab (840 mg) plus tiragolumab (420 mg) before surgery (experimental arm) or immediate surgery (control arm). The primary endpoint is the percentage of patients with complete or major pathological regression of the resected metastases (tumor regression grade 1/2, Rubbia-Brandt criteria). The statistical design follows Simon's two-stage approach with interim and final analyses comparing pathological response rates using descriptive and exploratory methods. Secondary endpoints include feasibility, safety, post-operative complications, and metabolic response by positron emission tomography. Exploratory studies characterize immune cell infiltration, tumor mutational burden, and circulating tumor DNA dynamics.
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