Clinical Management of Patients with Colorectal Liver Metastasis Using Hepatic Arterial Infusion

Melendez, Fidel David Huitzil; Kemeny, Nancy

doi:10.1017/cbo9780511722226.022

Cited by 1 publication

(1 citation statement)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In choosing a drug agent for HAI, the aim should be i) to increase local concentration which increases therapeutic response and ii) to decrease systemic exposure and toxicity [22]. Floxuridine (FUDR) is the most widely used agent in internal pumps because of the short half-life and high first-pass metabolism rate allowing for increased concentration of the drug in hepatic tumors and lower concentrations systemically [21].…”

Section: Rationale Of Hepatic Arterial Infusion Chemotherapymentioning

confidence: 99%

Treatment Options in Colorectal Liver Metastases: Hepatic Arterial Infusion

Zervoudakis

Boucher

Kemeny³

2017

Visc Med

View full text Add to dashboard Cite

Background: The liver is the most common site for metastases from colorectal cancer (CRC) with the majority of these patients having unresectable disease. Methods: This is a retrospective review of studies using hepatic arterial infusion (HAI) therapy to treat liver metastasis from CRC. A PubMed search of randomized controlled trials and retrospective studies from 2006 to present was conducted using the search terms ‘hepatic arterial infusion (HAI) therapy', ‘colorectal cancer', and ‘treatment of liver metastases'. Results: The first randomized studies comparing HAI to systemic therapy with 5-fluorouracil/leucovorin produced significantly higher response rates of 41 versus 14%. Systemic therapy has improved with the addition of irinotecan and oxaliplatin; however, the responses with HAI and these modern agents have also increased, with responses as high as 80%. For patients with wild-type KRAS, HAI and systemic therapy produced a median survival of 68 months. In patients with refractory disease, response rates are in the 30% range with a median survival of 20 months. Adjuvant HAI after liver resection has shown an increase of hepatic disease-free survival and overall disease-free survival when compared to systemic therapy alone in three of four randomized trials. A recent update of the adjuvant trials after liver resection at Memorial Sloan Kettering Cancer Center has shown a 5-year survival of 78%. Conclusion: HAI therapy has a role in treating hepatic metastases from CRC in both the resectable and unresectable setting.

show abstract

Section: Rationale Of Hepatic Arterial Infusion Chemotherapymentioning

confidence: 99%