Inclusion Criteria:

1. 18 years of age or older
2. Metastatic colorectal cancer; pathologically confirmed adenocarcinoma of the colon or rectum
3. ECOG performance status of 0 or 1
4. The most recent laboratory findings (including for liver and kidney) within 14 days prior to randomization remain within acceptable ranges Willingness of the patient and the sexual partner to use a highly effective contraceptive method during the course of the study
5. Able to sufficiently understand the clinical study and give written informed consent

Exclusion Criteria:

1. History of major hemorrhage
2. High risk of hemorrhage
3. History of other malignancies
4. Active ulcer
5. Patients using anti-coagulants and fibrinolytic drugs
6. Active Hepatitis B, or known HBs antigen positive
7. Prior treatment history with thrombomodulin alfa
8. Administration of another investigational medicinal product within 30 days prior to randomization
9. Patient is pregnant (positive urine human chorionic gonadotropin) or breastfeeding or intends to get pregnant during the Treatment period
10. Patients otherwise deemed as inappropriate to participate in the study by the Investigator