Study of Tumor Tissue Testing in Selecting Treatment for Patients With Metastatic or Locally Advanced Colorectal Cancer

DISEASE CHARACTERISTICS:

* Histologically confirmed colorectal adenocarcinoma meeting 1 of the following criteria:

  * Prior or recurrent primary adenocarcinoma of the colon or rectum with clinical or radiological evidence of locally advanced or metastatic disease
  * Metastatic adenocarcinoma with clinical and/or radiological evidence of colorectal primary tumor
* Inoperable metastatic or locoregional disease

  * Patients suitable for surgical resection of metastatic disease after response to first-line or adjuvant chemotherapy not allowed and should be considered for the New-EPOC trial study
* Unidimensionally measurable disease (according to RECIST criteria)
* Must have completed adjuvant chemotherapy with fluorouracil +/- leucovorin calcium (FU +/- LC), capecitabine, or oxaliplatin combinations in the past 6 months

  * QUASAR 2 patients who have continued bevacizumab for 6 months following completion of chemotherapy are allowed immediately after completion of bevacizumab
* Rectal chemotherapy with FU +/- LC or capecitabine for allowed if completed ≥ 1 month ago
* Single tumor block available
* No brain metastasis

PATIENT CHARACTERISTICS:

* WHO performance status 0-2
* ANC ≥ 1,500/mm\^3
* Platelet count ≥ 100,000/mm\^3
* Alkaline phosphatase ≤ 5 times upper limit of normal (ULN)
* Serum bilirubin ≤ 1.25 times ULN
* AST or ALT ≤ 2.5 times ULN
* Creatinine clearance ≥ 30 mL/min OR GFR ≥ 30 mL/min
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* Considered fit to undergo combination chemotherapy, with none of the following conditions:

  * Severe uncontrolled concurrent medical illness likely to interfere with protocol treatments, including any of the following:

    * Poorly controlled angina
    * Uncontrolled hypertension
    * Myocardial infarction within the past 3 months
  * History of severe peptic ulcer disease
  * Any psychiatric or neurological condition that is likely to compromise the patient's ability to give informed consent or to comply with oral medication
  * Nephrotic syndrome
  * Known coagulopathy
* No prior or current malignant disease that, in the judgement of the treating investigator, is likely to interfere with FOCUS 3 treatment or assessment of response
* No known hypersensitivity reactions to any of the components of the study treatments
* No personal or family history suggestive of dihydropyrimidine dehydrogenase (DPD) deficiency or with known DPD deficiency
* No history of uncontrolled seizures, central nervous system disorders, or psychiatric disability judged by the investigator to be clinically significant precluding informed consent
* Not able to attend or comply with treatment or follow-up scheduling

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
* At least 4 weeks since prior surgery
* No prior systemic chemotherapy for metastatic disease
* No ongoing therapy with cyclosporin-A
* No ongoing treatment with a contraindicated concomitant medication