Intra-arterial therapies for colorectal cancer liver metastases (radioembolization excluded)

Thierry de Baere, Lambros Tselikas, Valérie Boige, Michel Ducreux, David Malka, Diane Goéré, Eléonore Benahim, Frédéric Deschamps

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations

Abstract

During the past 20 years, advances in systemic therapies have improved overall survival of patients with Colorectal cancer Liver metastases (CRLM) from 6 to 24 months. By reaching CRLM via their preferential arterial vascularization, hepatic arterial infusion of chemotherapy (HAIC) has demonstrated improvement in response rate and deepness of response. Improvement in deepness of response is potentially helpful to convert no surgical patient to surgery. Recent HAIC regimens, including HAIC-FUDR plus systemic oxaliplatin/irinotecan, or HAIC-oxaliplatin plus systemic 5FU and cetuximab yielded a 92% and 90% response rate respectively, and conversion to R0 surgery in 47% and 42% of patients, respectively. When HAIC delivered a drug ineffective through intravenous delivery, this rechallenge provided 62% response rate for HAIC. Nowadays, port-catheter implanted percutaneously by radiologists has 95% feasibility with primary patency equivalent to that of surgically implanted catheters, and secondary patency superior after radiologic revision. Retrospective studies demonstrated prolonged DFS of HAIC over IV chemotherapy in the adjuvant setting after surgery of CRLM. Drug eluting beads loaded with irinotecan (DEBIRI) were developed as drug carrier and embolization platform for treatment of CRLM by chemoembolization. DEBIRI allows for a very high level of SN-38 (SN-38 is the active compound of irinotecan) and a very high rate of complete l response at pathologic studies of treated metastases. DEBIRI was compared to systemic FOLFIRI in a phase III randomized trial including 74 patients with benefit in overall survival and disease-free survival.

Original languageEnglish
Pages (from-to)402-406
Number of pages5
JournalBulletin du Cancer
Volume104
Issue number5
DOIs
StatePublished - May 2017
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2016 Société Française du Cancer

Keywords

  • Colorectal cancer
  • Hepatic arterial infusion chemotherapy
  • Liver metastases
  • Local treatment
  • Transarterial chemoembolization

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