Treating primary liver cancer with hepatic arterial infusion of floxuridine and dexamethasone: Does the addition of systemic bevacizumab improve results? Journal Article

   

Authors:	Kemeny, N. E.; Schwartz, L.; Gonen, M.; Yopp, A.; Gultekin, D.; D'Angelica, M. I.; Fong, Y. M.; Haviland, D.; Gewirtz, A. N.; Allen, P.; Jarnagin, W. R.
Article Title:	Treating primary liver cancer with hepatic arterial infusion of floxuridine and dexamethasone: Does the addition of systemic bevacizumab improve results?
Abstract:	Objectives: This study investigated the efficacy and safety of adding systemic (IV) bevacizumab (Bev) to hepatic arterial infusion (HAI) with floxuridine (FUDR)/dexamethasone (Dex) in unresectable primary liver cancer. Methods: Patients with unresectable intrahepatic cholangiocarcinoma (ICC) or hepatocellular carcinoma (HCC) were treated with HAI FUDR/Dex plus IV Bev. Results were compared to a recent study of HAI without Bev in a similar patient population. Results: Twenty-two patients (18 ICC, 4 HCC) were treated with HAI FUDR/Dex plus Bev; 7 (31.8%) had partial response and 15 (68.2%) had stable disease. Median survival was 31.1 months (CI 14.14-33.59), progression-free survival (PFS) 8.45 months (CI 5.53-11.05), and hepatic PFS 11.3 months (CI 7.93-15.69). In the previous trial with HAI alone (no Bev), the response was 50%; median survival, PFS, and hepatic PFS were 29.5, 7.3, and 10.1 months. In the present trial, bilirubin elevation (>2 mg/dl) was seen in 24% of patients and biliary stents were placed in 13.6%, versus 5.8 and 0%, respectively, in the HAI trial without Bev. Due to increased biliary toxicity, the trial was prematurely terminated. Conclusion: Adding Bev to HAI FUDR/Dex appeared to increase biliary toxicity without clear improvement in outcome (median PFS 8.45 vs. 7.3 months, and median survival 31.1 vs. 29.5 months, for HAI + Bev vs. HAI alone groups, respectively). Copyright (C) 2011 S. Karger AG, Basel
Keywords:	hepatocellular carcinoma; incidence; intrahepatic cholangiocarcinoma; resection; metastases; floxuridine; hepatic arterial infusion; united-states; colorectal-carcinoma; hepatocellular-carcinoma; mitomycin-c; resectability; intraarterial chemotherapy; rising
Journal Title:	Oncology
Volume:	80
Issue:	3-4
ISSN:	0030-2414
Publisher:	S. Karger AG
Date Published:	2011-01-01
Start Page:	153
End Page:	159
Language:	English
DOI:	10.1159/000324704
ACCESSION:	WOS:000292501200002
PROVIDER:	wos
PMCID:	PMC3123741
PUBMED:	21677464
Notes:	--- - Article - "Source: Wos"

https://synapse.mskcc.org/synapse/works/has_related_data_chk/10286