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Patients assigned to receive high-dose eicosapentaenoic acid (EPA), an omega-3 fatty acid, before and after surgery for colorectal cancer liver metastases had longer overall survival than those assigned to receive placebo, according to results of the phase 3 EMT2 trial presented at the ESMO Congress 2026, held in Madrid Oct. 23–27.

Surgery to remove colorectal cancer that has spread to the liver offers the possibility of long-term survival, but recurrence remains common. Preclinical and observational studies have suggested that EPA may have activity against colorectal cancer, while an earlier phase 2 trial indicated a possible survival benefit.

The randomized, double-blind, placebo-controlled EMT2 trial enrolled 418 patients scheduled for liver resection with curative intent at 13 U.K. hepatobiliary surgery centers. Patients were assigned to 4 g daily of EPA, as high-purity prescription icosapent ethyl, or mineral oil placebo. Treatment began at least one day before surgery and was planned to continue for two to four years, even after cancer progression. Other cancer treatments were broadly comparable, with 20% in each group receiving adjuvant chemotherapy.

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