Hepatic arterial infusion plus systemic irinotecan in patients with unresectable hepatic metastases from colorectal cancer previously treated with systemic oxaliplatin: A retrospective analysis Journal Article

  

Authors:	Gallagher, D. J.; Capanu, M.; Raggio, G.; Kemeny, N.
Article Title:	Hepatic arterial infusion plus systemic irinotecan in patients with unresectable hepatic metastases from colorectal cancer previously treated with systemic oxaliplatin: A retrospective analysis
Abstract:	Background: Response rates to systemic chemotherapy are low after tumor progression on oxaliplatin regimens. Hepatic arterial infusion (HAI) therapy in patients with tumor progression is a viable alternative. Patients and methods: Thirty-nine heavily pre-treated patients (all receiving prior oxaliplatin) with unresectable colorectal hepatic metastases were treated with systemic CPT-11 and concurrent HAI floxuridine (FUDR) and dexamethasone (DEX). Results: Partial responses were seen in 44% of patients. Median time to hepatic progression was 8.6 months, and median time to overall progression was 6.5 months. Median survival from time of initiation of HAI was 20.1 months [95% confidence interval (CI) 16.9-21.4] and from the initiation of treatment of metastatic disease, 32.01 months (95% CI 29.1-34.6). After a median follow-up of 19.1 months, seven patients (18%) proceeded to potentially curative surgery. Grade 3/4 toxic effects included neutropenia (13%), diarrhea (15%), intra-abdominal hemorrhage (2%), and bleeding duodenal ulcer (2%). Elevated liver function tests were seen, including bilirubin concentration >3 mg/dl (7%), alkaline phosphatase 2X baseline (20%), and aspartate aminotransferase >3X baseline (26%). Conclusions: HAI FUDR/DEX plus systemic CPT-11 achieves a response rate of 44% and a median overall survival of 20 months in heavily pre-treated patients with colorectal hepatic metastases all receiving previous oxaliplatin; 18% of patients proceeded to surgical resection or ablation. © 2007 European Society for Medical Oncology.
Keywords:	adult; cancer survival; clinical article; aged; aged, 80 and over; middle aged; retrospective studies; overall survival; fatigue; neutropenia; cancer growth; diarrhea; drug dose reduction; drug withdrawal; side effect; liver neoplasms; follow up; colorectal cancer; adenocarcinoma; antineoplastic combined chemotherapy protocols; camptothecin; dexamethasone; continuous infusion; retrospective study; irinotecan; dyspnea; febrile neutropenia; colorectal neoplasms; alkaline phosphatase; aspartate aminotransferase; bilirubin; survival time; liver metastasis; drug response; heparin; liver resection; colorectal surgery; inoperable cancer; liver function test; oxaliplatin; floxuridine; organoplatinum compounds; hepatic artery; metastatic; artery injury; hepatic arterial infusion; abdominal bleeding; duodenal ulcer bleeding
Journal Title:	Annals of Oncology
Volume:	18
Issue:	12
ISSN:	0923-7534
Publisher:	Oxford University Press
Date Published:	2007-12-01
Start Page:	1995
End Page:	1999
Language:	English
DOI:	10.1093/annonc/mdm405
PUBMED:	17962209
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-37349026722&partnerID=40&md5=a2ee7a2c74879b6ab9951eb6884cb09e
Notes:	--- - "Cited By (since 1996): 25" - "Export Date: 17 November 2011" - "CODEN: ANONE" - "Source: Scopus"

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