Irinotecan/Oxaliplatin/5-Fluorouracil/Leucovorin/Cetuximab As First Line Treatment In Colorectal Cancer

Inclusion Criteria: * Patients with histologically proven metastatic adenocarcinoma of the colon or rectum * Previous chemotherapy for metastatic disease not allowed. Patients who received prior adjuvant 5-FU-based chemotherapy are eligible if they have remained free of disease for at least 6 months after the completion of adjuvant therapy * Patients with operable metastatic disease are excluded from the study * Age 18-70 years * Performance status (ECOG) 0-1 * At least one bidimensionally measurable lesion of \>= 2cm * Life expectancy of at least 6 months * Adequate hematologic parameters (absolute neutrophil count \>= 1.5x109/L and platelets \>=100x109/L) * Creatinine and total bilirubin \< 1.25 times the upper limit of normal * Aspartate and alanine aminotransferase \< 3.0 times the upper limit of normal (\<5 times in case of liver mets) Exclusion Criteria: * Absence of active infection or malnutrition (loss of more than 20% of the body weight) * No history of a second primary tumor other than non-melanoma skin cancer or in situ cervical carcinoma. curatively treated * Patients treated with palliative radiotherapy had to have measurable metastatic disease outside the irradiation fields. * Patients with severe cardiac dysfunction, liver metastases involving more than 50% of the liver parenchyma, chronic diarrhea, or prior irradiation affecting more than 30% of the active bone marrow are excluded. * All patients will have to sign written informed consent in order to participate in the study