Transarterial Treatment of Colorectal Cancer Liver Metastases with Irinotecan-Loaded Drug-Eluting Beads: Technical Recommendations

Lencioni, Riccardo; Aliberti, Camillo; Baère, Thierry De; Garcia-Monaco, Ricardo; Narayanan, Govindarajan; O’Grady, Elizabeth; Rilling, William S.; Walker, Duncan; Martin, Robert C.G.

doi:10.1016/j.jvir.2013.11.027

Cited by 55 publications

(34 citation statements)

References 18 publications

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“…Median OS was 12 months (range=7-18 months) and 5.7 (range=1.5-7.7) months in the TACE and TACE-B groups, respectively. The median OS of the TACE-B group [12 (range=7-22) vs. 5.8 (range=1.5-7.7) months for TACE alone] was comparable to that previously reported for patients with CRC-LM treated with TACE alone [14 (range=1.3-25) months] (21). Many patients included in this study received more than two lines of chemotherapy, this may have influenced OS and reduced their life expectancy.…”

Section: Discussionsupporting

confidence: 70%

Chemoembolization Alone or Associated With Bevacizumab for Therapy of Colorectal Cancer Metastases: Preliminary Results of a Randomized Study

Fiorentini

Sarti

Nardella

et al. 2020

In Vivo

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Aim: to assess efficacy and safety of chemoembolization alone (TACE) and followed by bevacizumab (TACE-B) in patients with colorectal liver metastases (CRC-LM) (NCT03732235). Patients and Methods: The study included 30 consecutive patients with CRC-LM. They were informed about the types of treatment available: TACE with irinotecan loaded into polythylene glycol embolics alone or followed by bevacizumab therapy. Each patient underwent self-randomization and 17 chose TACE, whereas 13 chose TACE-B. Results: Tumor response at 3 months was complete response in one (6%) and four (31%) patients, and partial response in two (13%) and six (46%) patients, after TACE and TACE-B, respectively. No complications were observed during TACE. Most TACErelated adverse events were correlated with post-embolic syndrome. Conclusion: The preliminary results of the study showed that the TACE-B is feasible and tolerable. This study will be continued in order accrue a larger number of patients and longer follow-up.

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Section: Discussionsupporting

confidence: 70%

Chemoembolization Alone or Associated With Bevacizumab for Therapy of Colorectal Cancer Metastases: Preliminary Results of a Randomized Study

Fiorentini

Sarti

Nardella

et al. 2020

In Vivo

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“…These patients showed liver metastases from colorectal, cholangiocarcinoma, gastrinoma, gallbladder, pancreatic, gastrointestinal stromal, lung, kidney, breast, and larynx primary tumors. Another study conducted by Huppert et al using irinotecan loaded HepaSphere microspheres in metastatic colorectal cancer (mCRC) showed the HepaSphere microspheres to be safe and effective in mCRC treatment [22]. The preliminary results from our study also showed a promising result with the use of HepaSphere microspheres in liver cancer treatment.…”

Section: Discussionsupporting

confidence: 63%

Chemoembolization of liver cancer with drug-loading microsphere 50-100μm

et al. 2016

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Transcatheter arterial chemoembolization (TACE) is the mainstay of treatment for unresectable hepatocellular carcinoma (HCC). The efficacy of conventional TACE (cTACE) in liver metastases is not satisfactory, which might be due to the fact of embolic material used. Recently, as a new type of drug-loading microsphere, HepaSphere has been introduced in China. In this study, there were total 30 patients (18 males and 12 females) with liver cancer underwent embolization with Hepasphere microsphere. And a total of 44 TACE procedures were performed using 50-100μm HepaSphere. There were 16 patients diagnosed as HCC and 14 patients as liver metastases. The follow up period ranged from 3 to 15 months (median 10 months). Response rates were calculated on intention-to-treat basis. One month after TACE, total objective response was 63.3% and disease control rate was 86.7%. No severe complication (such as infection, liver abscess, abdominal bleeding, tumor rupture) was observed. In conclusion, chemoembolization with Hepasphere microsphere may be a safe and possibly effective palliative treatment for patients with liver cancer.

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“…However, future trials are needed with primary endpoints of downsizing to possible resection, improvements in the quality of life, and overall survival. We have established a simplified DEBIRI technique, which does not require these procedures to be performed in specialized centers but can be performed in both community and academic facilities safely and effectively . The procedure‐associated morbidities with DEBIRI have been well established and can be avoided with these types of technical modifications, which differ from conventional transarterial chemoembolization.…”

Section: Discussionmentioning

confidence: 99%

“…We have established a simplified DEBIRI technique, which does not require these procedures to be performed in specialized centers but can be performed in both community and academic facilities safely and effectively. 30,31 The procedure-associated morbidities with DEBIRI have been well established and can be avoided with these types of technical modifications, which differ from conventional transarterial chemoembolization. We have validated a generally less technically complex DEBIRI procedure that does not require hospitalization, uses a minimal percentage of patient controlled anesthesia (PCA), and, therefore, represents a less toxic, less expensive, and more convenient treatment alternative to other regional hepatic artery therapies.…”

Section: Discussionmentioning

confidence: 99%

Randomized controlled trial of irinotecan drug‐eluting beads with simultaneous FOLFOX and bevacizumab for patients with unresectable colorectal liver‐limited metastasis

Martin

Scoggins

Schreeder

et al. 2015

Cancer

Self Cite

133

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BACKGROUND:Reports have demonstrated the superior activity of combining both irinotecan and oxaliplatin (FOLFOXIRI) therapy. An option for gaining similar benefits with less toxicity would be the administration of irinotecan through a hepatic artery approach. The aim of this study was to assess the response and adverse event rates for irinotecan drug-eluting beads (DEBIRI) with folinic acid, 5-fluorouracil, and oxaliplatin (FOLFOX) and bevacizumab as a first-line treatment for unresectable colorectal liver metastasis. METH-ODS: Patients with colorectal liver metastases were randomly assigned to modified FOLFOX (mFOLFOX) and bevacizumab or mFOL-FOX6, bevacizumab, and DEBIRI (FOLFOX-DEBIRI). The primary endpoint was the response rate. The secondary endpoints were adverse events, the rate of conversion to resection, and progression-free survival. RESULTS: The intention-to-treat population comprised 70 patients: 10 patients in the pilot and then 30 patients randomly assigned to the FOLFOX-DEBIRI arm and 30 patients randomly assigned to the FOLFOX/bevacizumab arm. The 2 groups were similar with respect to the extent of liver involvement (30% vs 30%), but a greater percentage of patients in the FOLFOX-DEBIRI arm had an Eastern Cooperative Oncology Group performance status of 1 or 2 (57% vs 31%) and extrahepatic disease (56% vs 32%, P 5.02). The median numbers of chemotherapy cycles were similar (10 vs 9), and there were similar rates of grade 3/4 adverse events (54% for the FOLFOX-DEBIRI group vs 46% for the FOLFOX/ bevacizumab group). The overall response rate was significantly greater in the FOLFOX-DEBIRI arm versus the FOLFOX/bevacizumab arm at 2 (78% vs 54%, P 5.02), 4 (95% vs 70%, P 5.03), and 6 months (76% vs 60%, P 5.05). There was significantly more downsizing to resection in the FOLFOX-DEBIRI arm versus the FOLFOX/bevacizumab arm (35% vs 16%, P 5.05), and there was improved median progression-free survival (15.3 vs 7.6 months). CONCLUSIONS: The simultaneous administration of mFOLFOX6 (with or without bevacizumab) and DEBIRI through the hepatic artery (FOLFOX-DEBIRI) is safe and does not cause treatment delays or increase the systemic toxicity of chemotherapy. This strategy leads to improved overall response rates, improved hepatic progression-free survival, and more durable overall progression-free survival in patients downsized to resection. Cancer 2015;121:3649-58.

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Transarterial Treatment of Colorectal Cancer Liver Metastases with Irinotecan-Loaded Drug-Eluting Beads: Technical Recommendations

Cited by 55 publications

References 18 publications

Chemoembolization Alone or Associated With Bevacizumab for Therapy of Colorectal Cancer Metastases: Preliminary Results of a Randomized Study

Chemoembolization Alone or Associated With Bevacizumab for Therapy of Colorectal Cancer Metastases: Preliminary Results of a Randomized Study

Chemoembolization of liver cancer with drug-loading microsphere 50-100μm

Randomized controlled trial of irinotecan drug‐eluting beads with simultaneous FOLFOX and bevacizumab for patients with unresectable colorectal liver‐limited metastasis

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