Modern insights into hepatic arterial infusion for liver metastases from colorectal cancer

2011 ◽  
Vol 47 (18) ◽  
pp. 2681-2690 ◽  
Author(s):  
M. Bouchahda ◽  
F. Lévi ◽  
R. Adam ◽  
P. Rougier
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Hepatic Arterial Infusion ◽  
Arterial Infusion

Alternating Hepatic Arterial Infusion and Systemic Chemotherapy for Liver Metastases From Colorectal Cancer: A Phase II Trial Using Intermittent Percutaneous Hepatic Arterial Access

2001 ◽  
Vol 19 (9) ◽  
pp. 2404-2412 ◽  
Author(s):  
M. Sitki Copur ◽  
Mary Capadano ◽  
James Lynch ◽  
Timothy Goertzen ◽  
Timothy McCowan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Objective Response Rate ◽  
Response Rate ◽  
Group Performance ◽  
Objective Response ◽  
Hepatic Arterial Infusion ◽  
Fixed Dose ◽  
Arterial Infusion ◽  
Complete Cycle

PURPOSE: To evaluate the objective response to a short course of hepatic arterial infusion (HAI) using temporary, percutaneously placed catheters alternating with systemic prolonged continuous infusion fluorouracil (ci 5-FU) and daily oral leucovorin (L). PATIENTS AND METHODS: Eligible patients were previously untreated (except for adjuvant therapy) adults with liver-predominant metastases, with Eastern Cooperative Oncology Group performance status of 0 to 2. Treatment regimen included HAI with fluorodeoxyuridine (FUDR) 60 mg/m2/d and L 15 mg/m2/d continuously infused daily for 4 days. After a 1-week rest, ci 5-FU was administered through a central venous access device using a dose of 180 mg/m2/d with a fixed dose of oral L at 5 mg/m2/d for 21 out of 28 days. Cycles were repeated every 6 weeks. After four cycles of therapy, patients were maintained on ci 5-FU and daily oral L until evidence of progression. RESULTS: Forty-three patients were enrolled onto this trial. One patient was ineligible. The objective response rate for all patients (17 partial, zero complete) was 41% (95% confidence interval [CI], 26% to 56%). Five patients were not able to receive at least one complete cycle of HAI. Among patients who received at least one complete cycle of HAI, the response rate was 46% (95% CI, 30% to 62%). Five patients underwent a liver resection after enrolling onto the protocol. At the time of analysis, estimated median time to progression was 6 months, and estimated median overall survival was 13 months. CONCLUSION: The objective response rate was comparable to that achieved with more prolonged and more frequent HAI using FUDR. This approach should be studied as an acceptable alternative to surgically placed hepatic arterial catheters/pumps and may have a role as neoadjuvant therapy for liver metastases that are unresectable, as well as an adjuvant role for patients with resected hepatic metastatic colorectal cancer.

A phase I study of hepatic arterial infusion (HAI) of irinotecan in patients with inoperable liver metastases of colorectal cancer

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 3714-3714 ◽  
Author(s):  
T. J. Vogl ◽  
K. Eichler ◽  
M. G. Mack ◽  
J. O. Balzer ◽  
C. Herzog ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Phase I ◽  
Liver Metastases ◽  
Phase I Study ◽  
Hepatic Arterial Infusion ◽  
Arterial Infusion

Phase I/II study of irinotecan, UFT, and leucovorin with hepatic arterial infusion in colorectal cancer patients with unresectable liver metastases: Preliminary results

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 14549-14549
Author(s):  
T. Yamaguchi ◽  
H. Matsumoto ◽  
K. Takahashi ◽  
M. Yasutome ◽  
T. Mori
Keyword(s):  
Colorectal Cancer ◽  
Phase I ◽  
Liver Metastases ◽  
Phase Ii ◽  
Phase I Study ◽  
Phase Ii Study ◽  
Hepatic Arterial Infusion ◽  
Arterial Infusion ◽  
Unresectable Liver Metastases ◽  
Colorectal Cancer Patients

14549 Background: To determine the maximum-tolerated dose (MTD) and to evaluate the efficacy and tolerability of combination chemotherapy of irinotecan (CPT-11), UFT and leucovorin (LV) with hepatic arterial infusion (HAI) in colorectal cancer patients with unresectable liver metastases. Methods: Patients who had unresectable liver metastases from colorectal cancer were treated concurrently with intravenous CPT-11 on day1 of each 14-day treatment cycle with dose escalation, with orally UFT and LV on day 1–7 of each cycle, and with HAI of 5-FU on day 8–14 of each cycle. The primary objective of this phase I study was to determine the MTD of biweekly intravenous CPT-11 and UFT/LV with HAI of 5-FU. In the phase II study, the primary endpoint was to determine the response rate. Results: In the phase I study, the recommended dose of CPT-11 for phase II study was 140 mg/m2 combined with UFT 300 mg/m2/day, LV 75 mg/body/day and 5-FU 2,000 mg/body/week. Sixteen patients were enrolled onto the phase II study. The six patients treated at the recommended dose during the phase I study also included in the phase II analysis (n = 22). Median number of liver metastases was 12 (range, 3 to 35). Median size of maximum diameter was 6.3 cm (range, 2.0 to 12.0 cm). The most common adverse event was neutropenia. The complete and partial response rate totaled 81.8%. Median survival time has not been reached yet. Eleven patients (50.0%) were ultimately able to undergo liver resection. Conclusions: The combination chemotherapy of CPT-11 and UFT/LV with HAI was safe, well tolerate and effective in current population of the patients with unresectable liver metastases from colorectal cancer. Updated toxicity and response data will be available in the spring of 2007. No significant financial relationships to disclose.

Phase II Study of UFT with Leucovorin Plus Hepatic Arterial Infusion with Irinotecan, 5-Fluorouracil and Leucovorin for Non-Resectable Liver Metastases of Colorectal Cancer

Chemotherapy ◽  
2008 ◽  
Vol 55 (2) ◽  
pp. 76-82 ◽  
Author(s):  
Efraim Idelevich ◽  
Franklin Greif ◽  
Eli Mavor ◽  
Rafael Miller ◽  
Hanoch Kashtan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Phase Ii ◽  
Phase Ii Study ◽  
Hepatic Arterial Infusion ◽  
Arterial Infusion

Surgical Treatment of Colorectal Cancer Liver Metastases

2012 ◽  
pp. 209-212
Author(s):  
Steven A. Curley
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Treatment Strategies ◽  
Stage Iv ◽  
Hepatic Arterial Infusion ◽  
Arterial Infusion ◽  
Colorectal Cancer Liver Metastases ◽  
Stage Iv Colorectal Cancer ◽  
Cancer Metastases ◽  
Colorectal Cancer Metastases

Overview: Treatment strategies for patients with stage IV colorectal cancer have changed markedly in the last decade. Patients with colorectal cancer metastases to the liver have always been a fascinating group to consider biologically and for local-regional treatment strategies. In the late 1980s through the 1990s, resection was performed for a select subset of patients who had resectable disease. However, a high proportion of patients had bilobar unresectable disease and were treated with either 5-fluorouracil–based systemic chemotherapy or implanted hepatic arterial infusion pumps. The advent of the new millennium was associated with the availability of several new cytotoxic and biologic agents active in colorectal cancer. These agents have completely changed the approach to the treatment of patients with colorectal cancer liver metastases and thus have increased the complexity of the decision-making process for treatment of these patients.

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