Treatment of colorectal cancer: Hepatic metastasis

Fong, Yuman; Kemeny, Nancy E.; Paty, Philip B.; Blumgart, Leslie H.; Cohen, Alfred M.

doi:10.1002/(sici)1098-2388(199607/08)12:4<219::aid-ssu3>3.0.co;2-8

Cited by 150 publications

(28 citation statements)

References 139 publications

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“…The two groups were similar with respect to age, gender, nodal status of their primary tumour and pre-chemotherapy CEA. The PCI group had a significantly higher median (range) number of CRLM seen on imaging prior to chemotherapy [3 (1-14)] compared with the non-PCI group [2 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), that was no longer significant after chemotherapy. The median (range) size of the largest CRLM prechemotherapy was 33 (5-200) mm in the PCI group, similar to that in the non-PCI group [30 (4-130) mm, P = 0.545].…”

Section: Patient Demographics and Tumour Characteristicsmentioning

confidence: 99%

“…Colorectal cancer is common, with 39 991 new cases diagnosed in the UK in 2008 alone. 1 Of these patients, 15-20% will present with colorectal liver metastases (CRLM) 2 and a further 40-50% will develop CRLM within 3 years of successful resection of their primary tumour. 3 Hepatic resection offers the best chance of long-term survival, with 5-year survival rates of 37-50%.…”

Section: Introductionmentioning

confidence: 99%

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Detailed liver-specific imaging prior to pre-operative chemotherapy for colorectal liver metastases reduces intra-hepatic recurrence and the need for a repeat hepatectomy

Knowles

Welsh

Chandrakumaran

et al. 2012

HPB

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Background: Neoadjuvant chemotherapy for colorectal liver metastases (CRLM) reduces the accuracy of liver imaging which may understage patients pre‐operatively. Retrospective review of a prospective database to determine whether liver‐specific magnetic resonance imaging (MRI) prior to pre‐operative chemotherapy affects intra‐hepatic recurrence and long‐term outcome after hepatectomy. Patients and methods: Between 2003 and 2009, 242 patients with CRLM underwent a hepatectomy after ≥3 cycles of oxaliplatin or irinotecan‐based chemotherapy. All had a liver‐specific MRI immediately pre‐operatively. The outcome of patients who had a liver‐specific MRI prior to chemotherapy (PCI group, n= 92) was compared with those who did not (non‐PCI group, n= 150). Results: A liver‐specific MRI pre‐chemotherapy changed the staging in 56% of patients. At a median (range) follow‐up of 55 (6–94) months, there was a higher incidence of intra‐hepatic recurrence at a new site in the non‐PCI group (65% vs. 48% in the PCI group, P= 0.041) and an increased rate of recurrence in patients with the same number of lesions pre‐ and post‐chemotherapy [hazard ratio (HR) 2.02, 1:10–3.37, P= 0.024]. The non‐PCI group underwent more repeat hepatectomies than the PCI group (24.7% vs. 13%, P= 0.034), achieving similar long‐term survival. Conclusions: A liver‐specific MRI prior to chemotherapy reduces intra‐hepatic recurrence and avoids a repeat hepatectomy.

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Section: Patient Demographics and Tumour Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Detailed liver-specific imaging prior to pre-operative chemotherapy for colorectal liver metastases reduces intra-hepatic recurrence and the need for a repeat hepatectomy

Knowles

Welsh

Chandrakumaran

et al. 2012

HPB

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“…During 2010, 142,570 new cases of colorectal cancer were diagnosed and it was expected to cause about 51,370 deaths. Over 20% of patients present with metastatic (stage IV) colorectal cancer at the time of diagnosis, and up to 25% of this group will have isolated liver metastasis that is potentially resectable (Fong et al, 1996). The National Cancer Institute (www.cancer.gov) reported that the lifetime risk of being diagnosed with cancer of the colon or rectum is about one in 19 in males and about one in 20 in females in the US.…”

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confidence: 99%

Enhanced delivery of mda‐7/IL‐24 using a serotype chimeric adenovirus (Ad.5/3) in combination with the apogossypol derivative BI‐97C1 (Sabutoclax) improves therapeutic efficacy in low CAR colorectal cancer cells

Azab

Dash

Das

et al. 2012

Journal Cellular Physiology

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Adenovirus (Ad)-based gene therapy represents a potentially viable strategy for treating colorectal cancer. The infectivity of serotype 5 adenovirus (Ad.5), routinely used as a transgene delivery vector, is dependent on Coxsackie-adenovirus receptors (CAR). CAR expression is downregulated in many cancers thus preventing optimum therapeutic efficiency of Ad.5-based therapies. To overcome the low CAR problem, a serotype chimerism approach was used to generate a recombinant Ad (Ad.5/3) that is capable of infecting cancer cells via Ad.3 receptors in a CAR-independent manner. We evaluated the improved transgene delivery and efficacy of Ad.5/3 recombinant virus expressing melanoma differentiation associated gene-7/interleukin-24 (mda-7/IL-24), an effective wide-spectrum cancer-selective therapeutic. In low CAR human colorectal cancer cells RKO, wild-type Ad.5 virus expressing mda-7/IL-24 (Ad.5-mda-7) failed to infect efficiently resulting in lack of expression of MDA-7/IL-24 or induction of apoptosis. However, a recombinant Ad.5/3 virus expressing mda-7/IL-24 (Ad.5/3-mda-7) efficiently infected RKO cells resulting in higher MDA-7/IL-24 expression and inhibition of cell growth both in vitro and in nude mice xenograft models. Addition of the novel Bcl-2 family pharmacological inhibitor Apogossypol derivative BI-97C1 (Sabutoclax) significantly augmented the efficacy of Ad.5/3-mda-7. A combination regimen of suboptimal doses of Ad.5/3-mda-7 and BI-97C1 profoundly enhanced cytotoxicity in RKO cells both in vitro and in vivo. Considering the fact that Ad.5-mda-7 has demonstrated significant objective responses in a Phase I clinical trial for advanced solid tumors, Ad.5/3-mda-7 alone or in combination with BI-97C1 would be predicted to exert significantly improved therapeutic efficacy in colorectal cancer patients.

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“…Two-thirds of those who undergo successful resection, however, experience recurrence, presumably from microscopic residual disease (8). For patients with unresectable liver metastases, palliative treatment, in the form of chemotherapy, yields clinical response in only one-third of cases (9). Thus, active investigation seeks novel therapies that may improve outcome in both resectable and unresectable cases of this common disease entity.…”

mentioning

confidence: 99%

Oncolytic viral therapy for human colorectal cancer and liver metastases using a multi‐mutated herpes simplex virus type‐1 (G207)

et al. 1999

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G207 is a multi-mutated, replication-competent type-1 herpes simplex virus designed to target, infect, and lyse neurological tumors. This study examines the feasibility of using G207 in the treatment of human colorectal cancer and defines the biological determinants of its antitumor efficacy. This virus was tested on five human colorectal cancer cell lines in vitro to determine efficacy of infection and tumor cell kill. These results were correlated to measures of tumor cell proliferation. In vivo testing was performed through direct injections of G207 into xenografts of human colorectal cancer tumors grown in flanks of athymic rats. To evaluate an alternate method of administration, hepatic portal vein infusion of G207 was performed in a syngeneic model of liver metastases in Buffalo rats. Among the five cell lines tested, infection rates ranged between 10% and 90%, which correlated directly with S-phase fraction (8.6%-36.6%) and was proportional to response to G207 therapy in vitro (1%-93%). Direct injection of G207 into nude rat flank tumors suppressed tumor growth significantly vs. control (0.58 +/- 0.60 cm(3) vs. 9.16 +/- 3.70 cm(3), P<0. 0001). In vivo tumor suppression correlated with in vitro effect. In the syngeneic liver tumor model, portal infusion resulted in significant reduction in number of liver nodules (13 +/- 10 nodules in G207-treated livers vs. 80 +/- 30 nodules in control livers, P<0.05). G207 infects and kills human colorectal cancer cells efficiently. In vitro cytotoxicity assay and tumor S-phase fraction can be used to predict response to treatment in vivo. This antineoplastic agent can be delivered effectively by both direct tumor injection and regional vascular infusion. G207 should be investigated further as therapy for colorectal cancer and liver metastases.

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Treatment of colorectal cancer: Hepatic metastasis

Cited by 150 publications

References 139 publications

Detailed liver-specific imaging prior to pre-operative chemotherapy for colorectal liver metastases reduces intra-hepatic recurrence and the need for a repeat hepatectomy

Detailed liver-specific imaging prior to pre-operative chemotherapy for colorectal liver metastases reduces intra-hepatic recurrence and the need for a repeat hepatectomy

Enhanced delivery of mda‐7/IL‐24 using a serotype chimeric adenovirus (Ad.5/3) in combination with the apogossypol derivative BI‐97C1 (Sabutoclax) improves therapeutic efficacy in low CAR colorectal cancer cells

Oncolytic viral therapy for human colorectal cancer and liver metastases using a multi‐mutated herpes simplex virus type‐1 (G207)

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