Hepatic arterial infusion (HAI) chemotherapy via the medtronic pump-assessing dose delivery, response rates and toxicity.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16007-e16007
Author(s):  
Louise Catherine Connell ◽  
Laura Fiedler ◽  
Shannan Dickinson ◽  
Michele Ly ◽  
Kate Harrington ◽  
...  
Keyword(s):  
Partial Response ◽  
Hepatic Arterial Infusion ◽  
Response Rates ◽  
Dose Delivery ◽  
Arterial Infusion ◽  
Recist 1.1 ◽  
Pump Placement ◽  
Heavily Pretreated ◽  
Unresectable Colorectal Liver Metastases ◽  
Baseline Characteristics

e16007 Background: Due to the termination of the Codman pump, in order to administer hepatic arterial infusion (HAI) chemotherapy, the Medtronic pump has been used with the Codman catheter at MSKCC since 2018. Methods: Retrospective review of patients(pts) receiving HAI therapy via Medtronic pumps. Expected versus actual dose delivery of HAI FUDR, response rates and safety were reviewed. Results: Pts included; unresectable colorectal liver metastases (CRLM) (94 pts), resected CLRM (66 pts) and unresectable intrahepatic cholangiocarcinoma (ICC) (11 pts). Baseline characteristics of the 171 evaluable pts are shown in Table. In 120 pts with mCRC, 51.8% (n = 58) had 10 or more hepatic tumors and 23.2%( n = 26) had 50% or more liver involvement by metastases. 52 out of 171 pts (30.4%) had 100% of the expected FUDR doses by completion of the 3rdcycle. Another 49.7% (85/171) had greater than or equal to 50% of the expected FUDR dose. 96 pts had measurable disease (unresectable CLRM and ICC subgroups) evaluated by RECIST 1.1 with an MSK radiologist. The partial response for unresectable CRLM pts was 47% (41/87), and 28% (24/87) were stable. The partial response for ICC pts was 22% (2/9), and 33% (3/9) were stable. Conclusions: We evaluated 171 pts who were heavily pretreated and had extensive disease prior to pump placement. Partial response by RECIST 1.1 of 47% was evident in those pts with CRLM and 22% for pts with ICC. Dose delivery of HAI FUDR was compatible with that seen with the Codman pump and no increase in toxicity was noted. An updated analysis with additional evaluable pts will be presented at the meeting. [Table: see text]

Identification of patients who most benefit from hepatic arterial infusion (HAI) combined or not with systemic chemotherapy for the treatment of unresectable colorectal liver metastases

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 14565-14565
Author(s):  
P. Pilati ◽  
S. Mocellin ◽  
M. Lise ◽  
D. Nitti
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Systemic Chemotherapy ◽  
Tumor Response ◽  
Hepatic Arterial Infusion ◽  
Arterial Infusion ◽  
Tumor Load ◽  
Group A ◽  
Unresectable Colorectal Liver Metastases ◽  
Group B

14565 Background: Although locoregional treatments such as hepatic arterial infusion (HAI) claim the advantage of delivering higher doses of anticancer agents directly into the affected organ, there is substantial lack of evidence for benefit in terms of overall survival (OS). To test the hypothesis that systemic chemotherapy affects OS of patients with unresectable colorectal liver metastases treated with HAI. Furthermore, we investigated patient- and tumor-related predictive factors that might identify patients who most benefit from HAI regimen. Methods: In this retrospective study, 153 consecutive patients treated at our institution were considered. In group-A (n=72), patients were treated with HAI alone (floxuridine (FUDR) 0.2 mg/Kg + leucovorin (LV) 4 mg/m2 + desamethasone 20 mg 14 days/month) between 1994 and 1999. In group-B (n=81), patients were treated with the same HAI regimen combined with systemic chemotherapy (5-fluorouracil (5FU) 450 mg/m2 + LV 20 mg/m2) between 1999 and 2003. Results: No difference in OS was observed between group-A and group-B (median OS: 18.0 and 19.1 months, respectively). Considering all patients (group A + group B), low tumor load was associated with a better tumor response rate, but none of the traditional clinico-pathological prognostic factors correlated with OS. Median OS was better in patients with less than 50% of liver parenchyma involvement (21.3 vs 13.2 months; P<0.0001) as well as in responders (complete or partial response) versus non-responders (24.4 vs 13.4 months; P<0.0001). The combination of low tumor load with good tumor response to HAI was the only variable retained at multivariate analysis, and identified a subgroup of patients with a very favorable clinical outcome (median survival: 34.2 months; hazard ratio: 0.347, CI: 0.249–0.564, P< 0.0001). Conclusions: Combination with 5FU+LV systemic chemotherapy did not lead to an OS benefit over FUDR-based HAI alone. The identification of tumor response predictors is urgently needed, as it would lead to the tailored treatment of patients with low load but unresectable metastatic liver disease who most benefit from HAI therapy. No significant financial relationships to disclose.

The management of variant arterial anatomy during hepatic arterial infusion pump placement

2002 ◽  
Vol 9 (9) ◽  
pp. 875-880 ◽  
Author(s):  
Peter J. Allen ◽  
Alexander Stojadinovic ◽  
Leah Ben-Porat ◽  
Mithat Gonen ◽  
David Kooby ◽  
...  
Keyword(s):  
Infusion Pump ◽  
Hepatic Arterial Infusion ◽  
Arterial Infusion ◽  
Pump Placement ◽  
Arterial Anatomy

Sequential chemotherapy of hepatic arterial infusion of FOLFOX and FOLFIRI with intravenous bevacizumab in unresectable liver metastases from colorectal cancer after systemic chemotherapy failure.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14080-e14080
Author(s):  
Osamu Itano ◽  
Satoshi Itano ◽  
Hiroaki Nagamatsu ◽  
Hiromitsu Jinno ◽  
Yuko Kitagawa
Keyword(s):  
Liver Metastases ◽  
Disease Progression ◽  
Systemic Chemotherapy ◽  
Hepatic Arterial Infusion ◽  
Sequential Therapy ◽  
Sequential Chemotherapy ◽  
Arterial Infusion ◽  
History Of ◽  
Unresectable Colorectal Liver Metastases ◽  
Receive Treatment

e14080 Background: At present, systemic chemotherapy is the only established treatment in patients with unresectable colorectal liver metastases (CRLM). The regimen combining irinotecan or oxaliplatin to 5-FU/LV is recommended as a first and second line treatment. However, after failure of oxaliplatin- or irinotecan-based combination chemotherapy, there is no effective regimenremained. This pilot clinical trial explored the feasibility, safety, and efficacy of sequential chemotherapy of hepatic arterial infusion of FOLFOX and FOLFIRI with Intravenous Bevacizumab in unresectable CRLM after systemic chemotherapy failure. Methods: Patients with unresectable CRLM and history of systemic chemotherapy failure were treated with HAI oxaliplatin (35 mg/m2 2 hours: HAI-FOLFOX) or irinotecan (50 mg/m2 2 hours: HAI-FOLFIRI) followed by 5FU (1500mg 46hours) combined with intravenous Bevacizumab (200mg 90min) and LV (200mg 2hours) every 2 weeks until disease progression. Basically, HAI-FOLFOX was applied first, and after disease progression or limiting toxicity, HAI-FOLFIRI followed when the patient was still able to receive treatment. Results: Fourteen consecutive patients (median age 65 years; mean therapeutic term of prior systemic chemotherapy regimens,533 ± 266 days) were included, of whom 11 (79%) had previously received oxaliplatin (n =5), irinotecan (n = 2), or both (n = 4). Patients received a median of 13 cycles of HAI-FOLFOX (range 4–32) and among those, 7 patients sequentially received a median of 22 cycles of HAI-FOLFIRI (range 2–42). There was no technical nonfeasibility to discontinue treatment. The regimen was generally well tolerated; the most common side effects were grade 1 fatigue, anorexia, and/or hypertension. The complete and partial response rate totaled 71.4% in this sequential therapy. Median survival time was 20.1 months. Conclusions: A sequential chemotherapy of hepatic arterial infusion of FOLFOX and FOLFIRI with intravenous bevacizumab is feasible, safe, and shows promising activity in unresectable CRLM after systemic chemotherapy failure.

scholarly journals Robotic hepatic arterial infusion pump placement

HPB ◽  
2017 ◽  
Vol 19 (5) ◽  
pp. 429-435 ◽  
Author(s):  
Motaz Qadan ◽  
Michael I. D'Angelica ◽  
Nancy E. Kemeny ◽  
Andrea Cercek ◽  
T. Peter Kingham
Keyword(s):  
Infusion Pump ◽  
Hepatic Arterial Infusion ◽  
Arterial Infusion ◽  
Pump Placement
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