Hepatic artery infusion chemotherapy compared to transarterial radioembolization for unresectable colorectal liver metastases Journal Article

  

Authors:	Saadat, L. V.; Chou, J.; Gonen, M.; Lee, R. M.; Maithel, S. K.; Li, A.; Poultsides, G. A.; Aiken, T. J.; Schwartz, P. B.; Meram, E.; Abbott, D. E.; Robbins, K. J.; Fields, R. C.; Paranjpe, A.; Datta, J.; Connell, L. C.; Saltz, L.; Cercek, A.; Kemeny, N.; Sze, D. Y.; Yarmohammadi, H.; Sofocleous, C. T.; Jarnagin, W.; D’Angelica, M.
Article Title:	Hepatic artery infusion chemotherapy compared to transarterial radioembolization for unresectable colorectal liver metastases
Abstract:	Objective: This study evaluates outcomes for patients with unresectable colorectal liver metastases (CRLM) undergoing hepatic artery infusion chemotherapy (HAI) and transarterial radioembolization (TARE). Summary Background Data: The most common liver-directed therapies for unresectable CRLM include HAI and TARE. Methods: In this retrospective cohort study, patients with unresectable CRLM treated with HAI at one high-volume center were compared with patients treated with TARE at five other institutions. Propensity score matching was performed within lines of chemotherapy received prior to treatment (treatment-naïve; 1-line; 2-lines; 3-4 lines) using baseline demographics, extrahepatic disease (EHD), prior chemotherapy, disease-free interval, and interval from primary diagnosis to HAI/TARE. Overall survival (OS) analysis was conducted to compare the matched groups. Results: A total of 708 HAI patients and 481 TARE patients were identified. The majority of patients (84%) received chemotherapy prior to HAI/TARE. HAI patients were younger (median age:54 vs. 62) and more likely to have evidence of EHD at time of treatment (65% vs. 60%). Of the 493 patients who received 1-line of chemotherapy, 166 (34%) were matched. Among matched patients who received 1-line (HAI:83, TARE:83) or 2-lines of chemotherapy (HAI:80, TARE:80), TARE patients had a significantly increased risk of all-cause mortality compared to HAI [HR:1.46 (95%CI:1.02-2.08) and HR:1.96 (95%CI:1.32-2.89)]. More frequent conversion to resection and use of concurrent systemic chemotherapy were also seen in the HAI cohort. Among matched patients who received 3-4 lines of chemotherapy (HAI:50, TARE:50), there was no difference in OS between HAI and TARE [HR:0.88 (95%CI:0.57-1.35)] and rate of conversion to surgery was 4% for both groups. Conclusions: Within matched cohorts stratified by lines of therapy, there appear to be differences in survival for patients treated with HAI and TARE after first or second-line chemotherapy. Outcomes after TARE and HAI are not significantly different in the refractory setting. Copyright © 2025 Wolters Kluwer Health, Inc.
Keywords:	colorectal liver metastases; tare; hai
Journal Title:	Annals of Surgery
ISSN:	0003-4932
Publisher:	Lippincott Williams & Wilkins
Publication status:	Online ahead of print
Date Published:	2025-07-25
Online Publication Date:	2025-07-25
Language:	English
DOI:	10.1097/sla.0000000000006851
PROVIDER:	scopus
PUBMED:	40709764
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-105011660421&doi=10.1097%2fSLA.0000000000006851&partnerID=40&md5=4ecf06fcda470608480624a2003831f7
Notes:	The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Lily V. Saadat -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/227405