3550 POSTER Capecitabine plus hepatic intra-arterial epirubicin and cisplatin in unresectable biliary cancer: a phase II study

Pacetti, Paola; Mambrini, Andrea; Guglielmi, Alfredo; Iacono, Calogero; Torri, T; Orlandi, M.; Guadagni, Stefano; Fiorentini, G.; Cantore, Maurizio

doi:10.1016/s1359-6349(07)71053-4

Cited by 9 publications

(2 citation statements)

References 23 publications

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“…For the categorization of these data, the authors performed a literature review with specific inclusion and exclusion criteria. For the seven included studies with a total of 588 patients suffering from different malignant tumors (ICC, extrahepatic cholangiocarcinoma (ECC), gallbladder carcinoma, ampulla carcinoma, and hepatocellular carcinoma), pump-related complication rates ranged between 4.5 and 32.4% [23,24,25,26,27,28,29]. The toxicity rate reached 32.3% and included also a grade V adverse event (according to the common terminology criteria for adverse events (CTCAE)) [26,29].…”

Section: Locoregional Therapymentioning

confidence: 99%

“…For the seven included studies with a total of 588 patients suffering from different malignant tumors (ICC, extrahepatic cholangiocarcinoma (ECC), gallbladder carcinoma, ampulla carcinoma, and hepatocellular carcinoma), pump-related complication rates ranged between 4.5 and 32.4% [23,24,25,26,27,28,29]. The toxicity rate reached 32.3% and included also a grade V adverse event (according to the common terminology criteria for adverse events (CTCAE)) [26,29]. Partial response, stable disease, and progressive disease rates were 7.7 and 81.4%, 41.2 and 100% (only hepatocellular carcinoma, 61.1% for ICC), as well as 0 and 30.8%, respectively [23,24,25,28,29].…”

Section: Locoregional Therapymentioning

confidence: 99%

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Locoregional Therapies of Cholangiocarcinoma

2016

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Background: Cholangiocarcinoma (CC) is the second most primary liver malignancy with increasing incidence in Western countries. Currently, surgical R0 resection is regarded as the only potentially curative treatment. The results of systemic chemotherapy and best supportive care (BSC) in patients with metastatic disease are often disappointing in regard to toxicity, oncologic efficacy, and overall survival. In current practice, the use of different locoregional therapies is increasingly more accepted. Methods: A review of the literature on locoregional therapies for intrahepatic cholangiocarcinoma (ICC) was undertaken. Results: There are no prospective randomized controlled trials. For localized ICC, either primary or recurrent, radiofrequency ablation (RFA) is by far the most commonly used thermal ablation modality. Thereby, a systematic review and meta-analysis reports major complication in 3.8% as well as 1-, 3-, and 5-year overall survival rates of 82, 47, and 24%, respectively. In selected patients (e.g. with a tumor diameter of ≤3 cm), oncologic efficacy and survival after RFA are comparable with surgical resection. For diffuse ICC, different transarterial therapies, either chemotherapy-based (hepatic artery infusion (HAI), transarterial chemoembolization (TACE)) or radiotherapy-based (transarterial radioembolization (TARE)), show extremely promising results. With regard to controlled trials (transarterial therapy versus systemic chemotherapy, BSC or no treatment), tumor control is virtually always better for transarterial therapies and very often accompanied by a dramatic survival benefit and improvement of quality of life. Of note, the latter is the case not only for patients without extrahepatic metastatic disease but also for those with liver-dominant extrahepatic metastatic disease. There are other locoregional therapies such as microwave ablation, irreversible electroporation, and chemosaturation; however, the current data support their use only in controlled trials or as last-line therapy. Conclusion: Dedicated locoregional therapies are commonly used for primary and recurrent ICC as well as liver-only and liver-dominant extrahepatic metastatic disease. Currently, the best evidence and most promising results are available for RFA, HAI, TACE, and TARE. In cohort studies, the overall survival rates are similar to those obtained with surgery or systemic therapies. Prospective randomized controlled trials are warranted to compare safety and efficacy between different surgical, interventional, and systemic therapies, as well as their combinations.

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Section: Locoregional Therapymentioning

confidence: 99%

Section: Locoregional Therapymentioning

confidence: 99%

Locoregional Therapies of Cholangiocarcinoma

2016

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Unresectable intrahepatic cholangiocarcinoma: Systemic plus hepatic arterial infusion chemotherapy is associated with longer survival in comparison with systemic chemotherapy alone

Konstantinidis

Koerkamp

Gian

et al. 2015

Cancer

149

136

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Background Intrahepatic cholangiocarcinoma (ICC) is associated with poor survival. This study compares the outcome of patients with unresectable ICC treated with hepatic arterial infusion (HAI) plus systemic chemotherapy (SYS) to SYS alone. Methods Consecutive patients with ICC were retrospectively reviewed. Clinicopathologic data were reviewed. Survival rates were compared by Kaplan-Meier analysis and log rank test. Results Between 1/2000 and 8/2012, 525 patients with ICC were evaluated at Memorial Sloan Kettering Cancer Center and 236 patients with unresectable tumors (locally advanced or metastatic) were analyzed. Disease was confined to the liver in 104 patients who underwent treatment with combined HAI and SYS (78, 75%) or SYS alone (26, 25%). The response rate in the combined group was better than in those who received SYS alone, although this did not reach statistical significance (59% vs 39%, respectively; p=0.11). Overall survival in the combined group was longer compared to patients who received SYS alone (30.8 months vs 18.4 months, respectively; p<0.001), and this difference was maintained when patients with portal lymph node disease were included in the survival analysis (HAI and SYS n=93 with survival 29.6 months vs SYS n=74 with survival 15.9 months, respectively; p<0.001). Eight patients who initially presented with unresectable tumors responded enough to undergo complete resection and had a median overall survival of 37 months (range=10.4 – 92.3 months). Conclusion In patients with unresectable ICC confined to the liver or with limited regional nodal disease, combined SYS and HAI chemotherapy is associated with greater survival compared to SYS alone.

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Phase I clinical trial of hepatic arterial infusion of cisplatin in combination with intravenous liposomal doxorubicin in patients with advanced cancer and dominant liver involvement

Tsimberidou

Moulder

et al. 2010

Cancer Chemother Pharmacol

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Purpose We conducted a phase I study of hepatic arterial infusion (HAI) cisplatin and systemic chemotherapy in patients with advanced cancer and dominant liver involvement. Methods Patients were treated with HAI cisplatin 100–125 mg/m2 (and 3,000 IU heparin) intraarterially and liposomal doxorubicin (doxil) 20–35 mg/m2 IV (day 1) every 28 days. A “3 + 3” study design was used. Results Thirty patients were treated (median age, 56 years). Diagnoses were breast cancer (n = 11), colorectal cancer (n = 8), ocular melanoma (n = 4), and other (n = 7). The median number of prior therapies was 5. The maximum tolerated dose (MTD) was at the 100/35 mg/m2 level. Dose-limiting toxicities were Grade 4 neutropenia (2 of 4 patients), and Grade 4 thrombocytopenia (n = 1) at the cisplatin 125 mg/m2 and systemic doxil 35 mg/m2 dose level. The most common toxicities were nausea/vomiting and fatigue. Of 24 patients evaluable for response, 4 (17%) had a partial response (PR) and 7 (29%) had stable disease (SD) for ≥4 months. Of the 11 patients with breast cancer, 3 (27%) had a PR and 5 (45%) had SD for ≥4 months. Of 4 patients with ocular melanoma, 1 had a PR and 1 SD for 4 months. One patient with hepatocellular carcinoma had SD for 4 months. Of 12 evaluable patients treated at the MTD, 2 (17%) had a PR and 5 (42%) had SD. Conclusion The MTD was HAI cisplatin 100 mg/m2 and systemic doxil 35 mg/m2. This regimen demonstrated anti-tumor activity, especially in breast cancer.

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3550 POSTER Capecitabine plus hepatic intra-arterial epirubicin and cisplatin in unresectable biliary cancer: a phase II study

Cited by 9 publications

References 23 publications

Locoregional Therapies of Cholangiocarcinoma

Locoregional Therapies of Cholangiocarcinoma

Unresectable intrahepatic cholangiocarcinoma: Systemic plus hepatic arterial infusion chemotherapy is associated with longer survival in comparison with systemic chemotherapy alone

Phase I clinical trial of hepatic arterial infusion of cisplatin in combination with intravenous liposomal doxorubicin in patients with advanced cancer and dominant liver involvement

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