Synapse - Prospective phase II trial of combination hepatic artery infusion and systemic chemotherapy for unresectable colorectal liver metastases: Long term results and curative potential

Prospective phase II trial of combination hepatic artery infusion and systemic chemotherapy for unresectable colorectal liver metastases: Long term results and curative potential Journal Article

Authors:	Pak, L. M.; Kemeny, N. E.; Capanu, M.; Chou, J. F.; Boucher, T.; Cercek, A.; Balachandran, V. P.; Kingham, T. P.; Allen, P. J.; DeMatteo, R. P.; Jarnagin, W. R.; D'Angelica, M. I.
Article Title:	Prospective phase II trial of combination hepatic artery infusion and systemic chemotherapy for unresectable colorectal liver metastases: Long term results and curative potential
Abstract:	Background/Objectives: Combination hepatic artery infusion (HAI) and systemic (SYS) chemotherapy for unresectable CRLM results in high tumor-response rates. This study represents an update of long-term survival and conversion to resectability in patients with unresectable CRLM treated with HAI and SYS chemotherapy in a phase II study. Method: The primary endpoint was complete resection. Multivariate and landmark analysis assessed the effect of complete resection on progression-free (PFS) and overall survival (OS). Results: From 2007 to 2012, 64 patients with median of 13 tumors were enrolled; 67% had prior chemotherapy. 33 patients (52%) were converted to resection. Median follow-up among survivors was 81 months. Median PFS and OS were 13 and 38 months, respectively, with 5-year-OS of 36%. Chemotherapy-naïve patients had 5-year-OS of 51%. Conversion to resection was the only independent factor prognostic of improved PFS and OS. Nine of 64 patients (14%) are NED (five since initial resection, three after resection of recurrent disease, one from chemotherapy alone) at median follow-up of 86 months from treatment initiation, and 72 months from last operative intervention. Conclusion: Combination HAI and SYS is an effective therapy for high-volume unresectable CRLM, resulting in a high rate of resection, long-term survival, and the potential for cure. © 2017 Wiley Periodicals, Inc.
Keywords:	adult; cancer chemotherapy; cancer survival; treatment outcome; treatment response; disease-free survival; middle aged; survival analysis; cancer surgery; survival rate; major clinical study; overall survival; clinical trial; cancer recurrence; salvage therapy; bevacizumab; fluorouracil; ascites; cancer combination chemotherapy; chemoembolization; diarrhea; drug efficacy; drug safety; side effect; liver neoplasms; liver dysfunction; cancer patient; disease free survival; follow up; antineoplastic agent; prospective study; prospective studies; progression free survival; multiple cycle treatment; neutrophil count; phase 2 clinical trial; mucosa inflammation; nausea; vomiting; antineoplastic combined chemotherapy protocols; carcinoembryonic antigen; camptothecin; cohort analysis; hemoglobin; hemoglobin blood level; pathology; age; cancer survivor; irinotecan; abdominal pain; aspartate aminotransferase blood level; colorectal neoplasms; alkaline phosphatase; aspartate aminotransferase; bilirubin; intervention study; colorectal tumor; folinic acid; liver tumor; intraarterial drug administration; infusions, intra-arterial; hepatectomy; alkaline phosphatase blood level; inoperable cancer; leukocyte count; platinum complex; oncogene k ras; toxicity; gender; oxaliplatin; floxuridine; neurological complication; organoplatinum compounds; leucovorin; bilirubin blood level; percutaneous drainage; hepatic artery; platelet count; colorectal liver metastases; biliary tract disease; abscess; tumor ablation; secondary; biloma; wedge resection; systemic chemotherapy; independent variable; cancer prognosis; long term survival; colorectal liver metastasis; 5-fluoro-2'-deoxyuridine; humans; human; male; female; priority journal; article; hemihepatectomy; median survival time; deoxyuridine; patient history of chemotherapy; segmentectomy; hepatic artery infusion chemotherapy; analogs and derivatives; biliary toxicity
Journal Title:	Journal of Surgical Oncology
Volume:	117
Issue:	4
ISSN:	0022-4790
Publisher:	Wiley Blackwell
Date Published:	2018-03-15
Start Page:	634
End Page:	643
Language:	English
DOI:	10.1002/jso.24898
PUBMED:	29165816
PROVIDER:	scopus
PMCID:	PMC5878699
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85034773093&doi=10.1002%2fjso.24898&partnerID=40&md5=90f0f109fe3c82274c0f5e2b0434efc0
Notes:	Article -- Export Date: 1 May 2018 -- Source: Scopus