Response rates of hepatic arterial infusion pump therapy in patients with metastatic colorectal cancer liver metastases refractory to all standard chemotherapies.

Authors:

Andrea Cercek Taryn M Boucher Jill S Gluskin Ariel Aguiló Joanne F Chou Louise C Connell Marinela Capanu Diane Reidy-Lagunes Michael D'Angelica Nancy E Kemeny

J Surg Oncol 2016 Nov 26;114(6):655-663. Epub 2016 Aug 26.

Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

Background And Objectives: To evaluate the role of hepatic arterial infusion (HAI) in patients with metastatic colorectal cancer (mCRC) liver metastases (LM) refractory to oxaliplatin, irinotecan, and fluorouracil-based treatments.

Methods: A search identified patients with mCRC treated after tumor progression on at least three standard systemic therapies.

Results: One hundred and ten patients met criteria for inclusion (i.e., progression on at least three standard agents). Fifty seven patients had LM-only and 53 patients had LM and low volume extrahepatic metastases (LME). Patients with LM-only and LME had a response rate (RR) of 33% and 36%, median survival of 20 months and 11.4 months, respectively. Patients with LM-only had progression free survival of 6 months and hepatic progression free survival of 7.56 months. In a secondary analysis, 46 patients were RECIST-refractory to all standard therapies: LM-only (n = 24) and LME (n = 22). LM-only and LME had a RR of 29% and 36%, and median survival 17.2 months and 9.1 months, respectively.

Conclusions: Patients with refractory mCRC LM can achieve a response to HAI resulting in antitumor activity and improvement in survival. Responses are rarely seen in such heavily treated patients with systemic therapy alone, suggesting a regional directed approach is useful. J. Surg. Oncol. 2016;114:655-663. © 2016 Wiley Periodicals, Inc.