Inclusion Criteria:

1. Patients with confirmed diagnosis of stage IV (UICC) colorectal cancer with
unresectable liver metastases (primary tumour may be present) and k-ras wild-type
tumours

2. Patients had been treated and shown to be refractory to 5-FU (Capecitabine
allowed)/oxaliplatin and/or 5-FU/irinotecan. Prior therapy with VEGF-inhibitors (e.g
bevacizumab) is allowed

3. Patients with at least one measurable liver metastasis, with size > 1cm (RECIST
criteria)

4. Patients with liver only or liver dominant disease (defined as ≥ 50 % tumour burden
confined to the liver)

5. Patients with a portal vein not interfering with transarterial chemoembolization
(e.g. no thrombosis) as judged by the investigator

6. ECOG Performance status ≤ 2

7. Life expectancy > 3 months

8. Age ≥ 18 years.

9. At least 4 weeks since last administration of last chemotherapy and/or radiotherapy
(bone metastases may be allowed)

10. Patients who received VEGF-inhibition (e.g. with bevacizumab) in prior therapy are
eligible if stopped since 4-6 weeks before randomization

11. Haematologic function: ANC ≥ 1.5 x 109/L, platelets ≥ 75 x109/L

12. INR < 1.5 (patients on therapeutic anticoagulants are not eligible)

13. Adequate liver function as measured by serum transaminases (AST & ALT) ≤ 3 x ULN and
total bilirubin ≤ 1.5 x ULN

14. Adequate renal function: Serum creatinine ≤ 1.5 x ULN

15. Normal level of serum magnesium

16. Women of child bearing potential and fertile men are required to use effective
contraception (negative serum βHCG for women of child-bearing age

17. Signed, written informed consent

Exclusion Criteria:

1. Presence of CNS metastases

2. Contraindications to irinotecan therapy (Chronic inflammatory bowel disease and/or
bowel obstruction, history of severe hypersensitivity reactions to irinotecan
hydrochloride trihydrate)

3. Active bacterial, viral or fungal infection within 72 hours of study entry

4. Women who are pregnant or breast feeding

5. Allergy to contrast media

6. Presence of another concurrent malignancy. Prior malignancy in the last 5 years
except adequately treated basal or squamous cell skin cancer or carcinoma in situ of
the cervix

7. Any contraindication for hepatic embolisation procedures:

- Large shunt as determined by the investigator (pretesting with lung perfusion
scan not required)

- Severe atheromatosis

- Hepatofugal blood flow

8. Other significant medical or surgical condition, or any medication or treatment, that
would place the patient at undue risk, that would preclude the safe use of
chemoembolization or would interfere with study participation

9. Known hypersensitivity or contraindication to the drugs used in the trial (eg:
cetuximab, 5-HT3 receptor antagonist, dexamethasone, or any component of aprepitant)