Role of Hepatic Artery Infusion Pump Chemotherapy for Unresectable Colorectal Cancer Liver Metastases

2019 ◽  
pp. 313-327
Author(s):  
Jashodeep Datta ◽  
Michael I. D’Angelica
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Hepatic Artery ◽  
Infusion Pump ◽  
Hepatic Artery Infusion ◽  
Colorectal Cancer Liver Metastases

Effective salvage therapy of liver-only colorectal cancer metastases with chronomodulated irinotecan-fluorouracil-oxaliplatin via hepatic artery infusion

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 3585-3585
Author(s):  
M. Bouchahda ◽  
R. Adam ◽  
S. Giacchetti ◽  
X. M. Li ◽  
D. Castaing ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Hepatic Artery ◽  
Therapeutic Potential ◽  
Performance Status ◽  
Sensory Neuropathy ◽  
Progression Free Survival ◽  
Hepatic Artery Infusion ◽  
Colorectal Cancer Liver Metastases ◽  
Heavily Pretreated

3585 Background: Cell cycle and pharmacology genes are controlled by the molecular clock in normal liver but not in tumors (Filipski et al. JNCI 2005). As a result, circadian-based hepatic artery infusions of 3 main active drugs (ChronoHAI) could improve both tolerability and efficacy in patients (pts) with liver metastases from colorectal cancer. Methods: The therapeutic potential of 3-drug chronoHAI was evaluated in 28 heavily pretreated non hospitalized pts with metastatic colorectal cancer (MCC). They received 5-day (d) q21 d courses (c) with d1 irinotecan (160 mg/m2 from 2 to 8 am, peak at 5 am) and d2–5 oxaliplatin (20 mg/m2/d from 10 am to 10 pm, peak at 4 pm) and 5-fluorouracil (600 mg/m2/d from 10 pm to 10 am, peak at 4 am). 149 courses (c) were given (median, 5 ; 1–15) using a multichannel pump (Mélodie, Aguettant, F). Toxicity was assessed q21 d and response q3 c with CT scan. Results: Pt characteristics: prior chemotherapy lines 1/2/3/4+: 3/4/8/13 pts; WHO Performance Status 0/1/2/3 : 12/9/6/1 pts; median age: 63 years (32–73); liver only: 21 pts; liver and lung: 7 pts. Treatment was withdrawn for thrombosis (6 pts) and/or Grade (gr) 3 abdominal pain (3 pts). Grade 3–4 diarrhea and vomiting respectively occurred in 6 pts (21%) and 4 pts (14%) and were the main toxicities. Leucopenia, anemia and thrombocytopenia were respectively encountered in 5, 2 and 1 pt (< 18%). NCIC gr 3 sensory neuropathy occurred in 4 pts and alopecia in 3 pts. Of 25 pts with measurable lesions, disease progressed in 11 pts (exclusively outside the liver for 3 pts) and was controlled in 14 pts (56%), including 8 objective responses - 32% [95% C.L. 13.4 to 50.6]. Partial hepatectomy was performed in 3 pts with measurable disease (12%): R0 (2 PR) and R1 (1 SD). Median Progression free survival is 5 months [2.5 to 7.5] and median survival is 18.4 mo [10.5 to 26.3]. Five pts are alive at 2 to 51 mo. Conclusions: 3-drug chronoHAI is safe in heavily pretreated pts and achieves consistent activity against colorectal cancer liver metastases despite prior failure to oxaliplatin, irinotecan and fluorouracil. The addition of systemic molecular targeted therapy could be useful for preventing extra hepatic dissemination. Supported by ARTBC, Hôpital P. Brousse, Villejuif, France No significant financial relationships to disclose.

Laparoscopic placement of hepatic artery infusion catheter for colorectal cancer liver metastases

2021 ◽  
Vol 99 (3) ◽  
pp. 233
Author(s):  
Melissa Arias-Avilés ◽  
Èric Herrero-Fonollosa ◽  
Jaume Tur-Martínez ◽  
Esteban Cugat-Andorrà
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Hepatic Artery ◽  
Hepatic Artery Infusion ◽  
Colorectal Cancer Liver Metastases ◽  
Infusion Catheter

scholarly journals Combined Systemic and Hepatic Artery Infusion Pump Chemo-Therapy as a Liver-Directed Therapy for Colorectal Liver Metastasis-Review of Literature and Case Discussion

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1283
Author(s):  
Salman Chaudhry ◽  
Ryan C. Fields ◽  
Patrick M. Grierson ◽  
Kian-Huat Lim
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastasis ◽  
Liver Metastases ◽  
Disease Control ◽  
Hepatic Artery ◽  
Systemic Chemotherapy ◽  
Infusion Pump ◽  
Colorectal Metastases ◽  
Hepatic Artery Infusion ◽  
Systemic Treatments

Colorectal cancer (CRC) is the third most prevalent malignancy and the second most common cause of death in the US. Liver is the most common site of colorectal metastases. About 13% of patients with colorectal cancer have liver metastasis on initial presentation and 50% develop them during the disease course. Although systemic chemotherapy and immunotherapy are the mainstay treatment for patients with metastatic disease, for selected patients with predominant liver metastasis, liver-directed approaches may provide prolonged disease control when combined with systemic treatments. Hepatic artery infusion pump (HAIP) chemotherapy is an approach which allows direct infusion of chemotherapeutic into the liver and is especially useful in the setting of multifocal liver metastases. When combined with systemic chemotherapy, HAIP improves the response rate, provides more durable disease control, and in some patients leads to successful resection. To ensure safety, use of HAIP requires multidisciplinary collaboration between interventional radiologists, medical oncologists, hepatobiliary surgeons and treatment nurses. Here, we review the benefits and potential risks with this approach and provide our single institution experience on two CRC patients successfully treated with HAIP in combination with systemic chemotherapy. We provide our recommendations in adopting this technique in the current era for patient with colorectal liver metastases.

LIver Resection and role of Extended Histology (LiREcH study) in patients with multifocal colorectal cancer liver metastases

HPB ◽  
2021 ◽  
Author(s):  
Hassaan Bari ◽  
Umasankar M. Thiyagarajan ◽  
Rachel Brown ◽  
Keith J. Roberts ◽  
Nikolaos Chatzizacharias ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Resection ◽  
Liver Metastases ◽  
Colorectal Cancer Liver Metastases

scholarly journals Hepatic artery infusion pump for nasopharyngeal carcinoma with liver metastasis

2019 ◽  
Vol 37 (2) ◽  
pp. 333-339
Author(s):  
Changli Peng ◽  
Chunhui Zhou ◽  
Gang Li ◽  
Haiping Li ◽  
Liangrong Shi
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Liver Metastases ◽  
Hepatic Artery ◽  
Infusion Pump ◽  
Objective Response ◽  
Complete Response ◽  
Hepatic Artery Infusion ◽  
Significant Difference ◽  
Extrahepatic Metastases ◽  
Grade 3

AbstractTo evaluate the benefits and risks of hepatic artery infusion (HAI) gemcitabine and floxuridine (FUDR) in patients with nasopharyngeal carcinoma liver metastases. HAI catheter systems were implanted under the guide of digital subtract angiography (DSA) in 16 patients with unresectable nasopharyngeal carcinoma liver metastases. HAI gemcitabine and FUDR in combination with radiotherapy and systemic chemotherapy were delivered. Disease control rate (DCR) of intrahepatic lesions is 100%, objective response rate (ORR) of intrahepatic lesions is 87.5%, including 4 patients (25%) with complete response (CR), 10 patients (62.5%) with partial response (PR) and 2 patients (12.5%) with stable disease (SD). The median overall survival (mOS) was 30 months. There was no significant difference between patients with < 9 intrahepatic lesions and patients with ≥ 9 intrahepatic lesions (31 months vs. 24 months, P = 0.562). Patients without extrahepatic metastases has longer survival than patients with extrahepatic metastases (31 months vs. 17 months, P = 0.005). In all 72 cycles of HAI, the main grade 3/4 toxicities related to HAI include: leukopenia occur in 8 cycles (11.1%), thrombocytopenia in 5 cycles (6.9%), AST/ALT elevation in 12 cycles (16.7). Catheter related complications occurred in 2 patients (12.5%). HAI gemcitabine and FUDR is effective to improve DCR of intrahepatic lesions and prolong mOS for patients with nasopharyngeal carcinoma liver metastases, and is associated with a relative low rate of toxicity.

Sign in / Sign up

Export Citation Format

Share Document