Isolated chemotherapeutic perfusion of the pelvis for advanced rectal cancer

Wanebo, Harold J.; Belliveau, James F.; Begossi, Giovanni; Levy, A.

doi:10.1046/j.1463-1318.2003.00523.x

Cited by 14 publications

(6 citation statements)

References 22 publications

(18 reference statements)

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“…There is some evidence that fluorouracil (5-FU)-based chemotherapy plus cisplatin has some benefit with a response rate of about 50% and a median overall survival of 13–55 months [3, 4, 5]. In selected patients, an aggressive multimodality approach including resection of metastases, irradiation of para-aortic lymph nodes or intra-arterial chemotherapy results in long-term survival [6, 7]. In this article, we report about a 64-year-old male patient with metastatic anal cancer who failed first-line palliative therapy with cisplatin and 5-FU but who showed a good response to second-line therapy with irinotecan, leucovorin, 5-FU and cetuximab, a monoclonal antibody against the epidermal growth factor receptor (EGFR).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Cetuximab in Combination with FOLFIRI in a Patient with KRAS Wild-Type Metastatic Anal Cancer

Barmettler¹,

Komminoth

Schmid³

et al. 2012

Case Rep Oncol

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Anal canal cancer is a rare tumor without clear treatment evidence in the metastatic setting. In terms of the bad prognosis of patients with metastatic anal cancer, further therapeutic options are urgently needed. In this paper we present the case of a 64-year-old man suffering from undifferentiated squamous cell carcinoma with liver metastases. After progression on cisplatin and fluorouracil, tumor tissue was analyzed with respect to anti-EGFR therapy with cetuximab. There was no KRAS mutation and the EGFR expression level in the tumor tissue was 2+; ideal conditions for the immunotherapy. Encouraged by these results we started a therapy using FOLFIRI in combination with cetuximab. Fortunately the patient showed a partial response after 6 cycles. On patient’s preference we did a therapy break of 6 weeks. Within this time period the disease was progressive indicating its aggressiveness. However, the same immunotherapy was able to stabilize the disease for a further 3 months. The patient died 21 months after diagnosis because of liver failure. Nevertheless, from our perspective the combination of FOLFIRI and cetuximab is quite a promising therapeutic option for patients with metastatic anal cancer. Potential predictive factors of the immunochemotherapy are discussed in this paper.

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Section: Introductionmentioning

confidence: 99%

Efficacy of Cetuximab in Combination with FOLFIRI in a Patient with KRAS Wild-Type Metastatic Anal Cancer

Barmettler¹,

Komminoth

Schmid³

et al. 2012

Case Rep Oncol

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“…In most of these reports cisplatin was used as backbone of treatment resulting in response rates of about 50% and median overall survival of 15–33 months depending on patient selection. In single patients, an aggressive multimodality approach including resection of (liver) metastases, irradiation of para-aortic lymph nodes or intra-arterial chemotherapy provided long-term survival [11,12]. The largest prospective clinical trial published thus far was conducted by the Eastern Cooperative Group (ECOG) [10].…”

Section: Introductionmentioning

confidence: 99%

Cetuximab-Based Treatment of Metastatic Anal Cancer: Correlation of Response with KRAS Mutational Status

Lukan¹,

Ströbel²,

Willer

et al. 2009

Oncology

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Background: No standard chemotherapy regimen can be defined for patients with metastatic squamous cell carcinoma of the anus due to the low incidence of this disease and the high cure rate of localized tumors. Anal cancers universally express the epidermal growth factor receptor (EGFR) and KRAS mutations have not been reported in anal cancer thus far. Methods: We report on 7 patients with metastatic anal cancer treated with cetuximab – a chimeric antibody against EGFR – on a compassionate use basis along with the results of KRAS mutational analysis. Results: Marked tumor shrinkage was noted in several patients using cetuximab monotherapy or cetuximab/irinotecan combination as first or subsequent treatment line (usually after failure of cisplatin-based regimens). Two out of seven patients harbored KRAS mutations. Both patients had progressive disease receiving cetuximab, while the remaining 5 patients had either a partial remission (n = 3), a minor remission (n = 1) or no change lasting ≥6 months after previous rapid tumor progression. Conclusion: Cetuximab-based treatment appears to be a valuable treatment option for patients with metastatic KRAS wild-type anal cancer after failure of or as an alternative to cisplatin/5-fluorouracil-based therapy.

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“…Eine weitere Option in der palliativen Therapie ist die isolierte Chemotherapiegabe in die Beckengefäße. Wanebo et al [39] konnten durch die isolierte Beckenperfusion mit 5-FU, Cisplatin und Mitomycin eine Verbesserung der Schmerzsymptomatik bei 11 von 14 behandelten Patienten erreichen, die über 1-4 Monate anhielt [39]. Eine vergleichende Studie zu anderen Optionen einer palliativen Therapie fehlt, der Stellenwert dieser Methode kann daher zurzeit nicht beurteilt werden.…”

Section: Palliative Therapieunclassified

Vorgehen beim lokoregionären Rezidiv des Rektumkarzinoms

Weitz¹,

Ulrich²,

Koch³

et al. 2005

Visc Med

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Trotz optimierter chirurgischer Technik und multimodalen Therapiekonzepten mit einer deutlichen Senkung der Lokalrezidivrate stellen Lokalrezidive des Rektumkarzinoms weiterhin eine therapeutische Herausforderung dar. Eine Kuration ist nur durch eine vollständige Resektion möglich, wobei der Eingriff mit einer signifikanten Morbidität assoziiert ist. Ob durch die Anwendung multimodaler Therapiekonzepte die Prognose dieser Patienten verbessert werden kann, ist formal nicht belegt, aber wahrscheinlich. Auch die palliative Resektion von Lokalrezidiven ist möglicherweise sinnvoll. Eine Alternative hierzu stellt die perkutane Bestrahlung dar. Der Stellenwert alternativer Therapieverfahren, z.B. Hyperthermie oder isolierte Beckenperfusion, in dieser Situation muss in weiteren Studien definiert werden. Das Hauptaugenmerk sollte aber auf der Vermeidung von Lokalrezidiven durch eine adäquate Primärtherapie von Rektumkarzinomen liegen.

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Isolated chemotherapeutic perfusion of the pelvis for advanced rectal cancer

Abstract: Isolated chemotherapeutic perfusion of the pelvis provides excellent palliation for patients with advanced or pelvic recurrence of rectal cancer or epidermoid cancer of anorectum and may potentiate resection in selected patients.

Cited by 14 publications

References 22 publications

Efficacy of Cetuximab in Combination with FOLFIRI in a Patient with KRAS Wild-Type Metastatic Anal Cancer

Efficacy of Cetuximab in Combination with FOLFIRI in a Patient with KRAS Wild-Type Metastatic Anal Cancer

Cetuximab-Based Treatment of Metastatic Anal Cancer: Correlation of Response with KRAS Mutational Status

Vorgehen beim lokoregionären Rezidiv des Rektumkarzinoms

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