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Olaguoke Akinwande, Meaghan Dendy, Johannes M Ludwig, Hyun S Kim
PURPOSE: To systematically review the safety and efficacy of transarterial drug-eluting beads, irinotecan (DEBIRI) for the treatment of pretreated patients with unresectable colorectal liver metastases (CRLM). METHODS: A systematic search of the current literature was conducted to extract publications reporting on the use of DEBIRI for CRLM. Data on the safety and efficacy was extracted and tabulated. Weighted average values (WAV) were calculated for each variable to provide a single value representing the pooled safety and efficacy data...
September 2017: Surgical Oncology
B Maher, E Ryan, M Little, P Boardman, B Stedman
Colorectal cancer remains a leading cause of cancer-related death in Europe. Approximately one-quarter of patients have synchronous hepatic metastases and metachronous liver metastases occur in a further 30%. The scope of surgery in management of colorectal metastases has evolved to include selected patients with extra-hepatic disease for whom R0 resection is considered feasible; however, locoregional treatments are increasingly recognised as viable management options in those patients deemed unsuitable for surgery and there is an expanding body of evidence regarding their ability to achieve local control and increase progression-free survival in the liver...
August 2017: Clinical Radiology
Vincenzo Di Noia, Michele Basso, Valentina Marsico, Eleonora Cerchiaro, Sabrina Rossi, Ettore D'Argento, Antonia Strippoli, Giovanni Schinzari, Roberto Iezzi, Alessandra Cassano, Carlo Barone
AIM: This single institution Phase II study evaluated drug-eluting beads loaded with irinotecan (DEBIRI) plus capecitabine in pretreated patients with colorectal cancer liver metastases. PATIENTS & METHODS: Forty patients with liver-limited or liver-dominant disease, who have failed at least two previous lines of chemotherapy, underwent either four DEBIRI at 2-week interval or two DEBIRI every 4 weeks for bilobar or single-lobe metastases, respectively. Capecitabine was given at 1000 mg/m(2) twice daily on days 1-14 every 3 weeks...
April 25, 2017: Future Oncology
Germano Scevola, Giorgio Loreni, Marco Rastelli, Stefano Sposato, Sara Ramponi, Vittorio Miele
No abstract text is available yet for this article.
May 2017: Medical Oncology
Germano Scevola, Giorgio Loreni, Marco Rastelli, Stefano Sposato, Sara Ramponi, Vittorio Miele
To evaluate safety, efficacy of drug-eluting beads with irinotecan (DEBIRI) on local response and survival of patients affected by colorectal liver metastases (CRLM) progressing during or after second line was evaluated. Sixty-two patients, with colorectal liver metastases, not suitable for surgery or thermal ablation treatments, progressing during or within 6 month from the end of second-line chemotherapy, were treated with DEBIRI chemoembolization between February 2009 and July 2014. CRLM were histologically confirmed...
March 2017: Medical Oncology
Shamar Young, Donna D'Souza, Siobhan Flanagan, Jafar Golzarian
Colorectal cancer is a common malignancy that most commonly metastasizes to the liver. There has been considerable effort in developing new treatment options for these patients. One method that has been developed for the treatment of colorectal metastases to the liver is irinotecan-loaded drug-eluting bead (DEBIRI) embolization. This article reviews the current literature on DEBIRI and discusses the state of current knowledge and possible areas of future investigation.
April 2017: Cardiovascular and Interventional Radiology
Girolamo Ranieri, Artor Niccoli Asabella, Corinna Altini, Vito Fazio, Luciana Caporusso, Ilaria Marech, Gianluca Vinciarelli, Francesco Macina, Dario de Ceglia, Margherita Fanelli, Michele Ammendola, Giuseppe Rubini, Cosmo Damiano Gadaleta
BACKGROUND: The main aim of this prospective study was to evaluate the efficacy of drug-eluting beads with irinotecan (DEBIRI) for liver metastases from colorectal cancer. Secondary aims were to evaluate survival and toxicity. METHODS: Twenty-five patients with metastases in <50% of the liver and without extrahepatic involvement were enrolled. Treatment response assessment was performed by multidetector contrast enhancement computed tomography (MDCT) with evaluation of the enhancement pattern of the target lesion and tumor response rates according to modified Response Evaluation Criteria in Solid Tumors (mRECIST, Version 1...
2016: OncoTargets and Therapy
Thierry de Baere, Lambros Tselikas, Valérie Boige, Michel Ducreux, David Malka, Diane Goéré, Eléonore Benahim, Frédéric Deschamps
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...
May 2017: Bulletin du Cancer
R P Jones, H Z Malik, S W Fenwick, M Terlizzo, E O'Grady, S Stremitzer, T Gruenberger, M Rees, G Plant, J Figueras, M Albiol, R Adam, S Awad, G J Poston
PURPOSE: Perioperative chemotherapy confers a 3-year progression free survival advantage following resection of colorectal liver metastases (CRLM), but is associated with significant toxicity. Chemoembolisation using drug eluting PVA microspheres loaded with irinotecan (DEBIRI) allows sustained delivery of drug directly to tumour, maximising response whilst minimising systemic exposure. This phase II single arm study examined the safety and feasibility of DEBIRI before resection of CRLM...
December 2016: European Journal of Surgical Oncology
Massimo Venturini, Claudio Sallemi, Giulia Agostini, Paolo Marra, Stefano Cereda, Michele Reni, Luca Aldrighetti, Francesco De Cobelli, Alessandro Del Maschio
OBJECTIVE: The aim of our preliminary study was to compare the efficacy of drug-eluting beads preloaded with irinotecan (DEBIRI) vs drug-eluting beads preloaded with doxorubicin (DEBDOX) as second-line treatment of unresectable liver metastases from cholangiocarcinoma (CCA). METHODS: In 2013, 10 patients affected by multiple liver metastases from CCA, resistant to the first-line chemotherapy regimen, were enrolled: 5 patients were submitted to lobar/segmental transarterial chemoembolization (TACE) with DEBIRI (100-mg irinotecan/1 vial) and 5 patients with DEBDOX (50-mg doxorubicin/1 vial), performed every 3 weeks...
November 2016: British Journal of Radiology
Olaguoke Akinwande, Charles Scoggins, Robert C G Martin
AIM: To report our early experience on the feasibility and safety of 70-150 μm drug-eluting beads loaded with irinotecan (M1-DEBIRI) for treating unresectable hepatic colorectal metastases. PATIENTS AND METHODS: An Institutional Review Board-approved, prospectively maintained, multi-institutional registry was evaluated from 2/2009 to 8/2013. Fifteen consecutive patients presenting with liver-dominant metastatic colorectal cancer were treated with M1-DEBIRI. Kaplan-Meier statistics was used to evaluate hepatic progression-free-survival and overall survival...
July 2016: Anticancer Research
Roberto Bini, Simone Comelli, Renzo Leli, Giacomo Paolo Vaudano, Daniele Savio, Tiziana Viora, Alfredo Addeo
PURPOSE: Assess the feasibility, safety and efficacy of TACE with irinotecan loaded micro particles (debiri) for the treatment of locally advanced rectal cancer patients. RESULTS: We assessed the Edmonton Symptom Assessment System (ESAS). The tool is designed to assess nine common symptoms in cancer patients: pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, wellbeing and shortness of breath. The ESAS score was 7 in 10/12 (83%) patients before treatment and 6 in 2/12 (16...
July 19, 2016: Oncotarget
Neal Bhutiani, Olaguoke Akinwande, Robert C G Martin
INTRODUCTION: Response rates to systemic chemotherapy for patients who have failed irinotecan-based chemotherapy for liver-dominant metastatic colorectal cancer range between 10 and 18 % with overall survival between 7 and 9 months. The aim of this study was to assess the efficacy and safety of hepatic arterial irinotecan therapy in patients with hepatic-dominant metastatic colorectal cancer who had failed systemic irinotecan. METHODS: This was a multi-institutional, multi-national, analysis of patients who received DEBIRI in the setting of unresectable liver-dominant metastatic colorectal cancer...
May 2016: World Journal of Surgery
Andrew L Lewis, Matthew R Dreher, Vincent O'Byrne, David Grey, Marcus Caine, Anthony Dunn, Yiqing Tang, Brenda Hall, Kirk D Fowers, Carmen Gacchina Johnson, Karun V Sharma, Bradford J Wood
Clinical use of DC Bead™ loaded with doxorubicin (DEBDOX™) or irinotecan (DEBIRI™), for the treatment of primary and secondary tumours of the liver respectively, is showing great promise. Recently there has been a tendency to select smaller bead size ranges to treat tumours in an effort to allow more drug dose to be administered, improve tumoural penetration and resultant drug delivery and tumour coverage. Herein we describe the development and performance characterisation of a new DC Bead size range (DC BeadM1 (TM), 70-150 μm) capable of an increased bead delivery in the distal vasculature, corresponding to greater tumour coverage and drug dose delivered...
January 2016: Journal of Materials Science. Materials in Medicine
Robert C G Martin, Charles R Scoggins, Marshall Schreeder, William S Rilling, Christopher J Laing, Clifton M Tatum, Lawrence R Kelly, Ricardo D Garcia-Monaco, Vivek R Sharma, Todd S Crocenzi, Steven M Strasberg
BACKGROUND: Reports have demonstrated the superior activity of combining both irinotecan and oxaliplatin (FOLFOXIRI) therapy. An option for gaining similar benefits with less toxicity would be the administration of irinotecan through a hepatic artery approach. The aim of this study was to assess the response and adverse event rates for irinotecan drug-eluting beads (DEBIRI) with folinic acid, 5-fluorouracil, and oxaliplatin (FOLFOX) and bevacizumab as a first-line treatment for unresectable colorectal liver metastasis...
October 15, 2015: Cancer
Simon Pernot, Pascal Artru, François Mithieux, Julien Marsot, Emmanuel Watkin, Olivier Pellerin, Gerard Lledo, Philippe Chalabreysse, Jérome Desramé, Julien Taieb
INTRODUCTION: Most liver metastases from colorectal cancer (CRC) are unresectable at diagnosis. Systemic chemotherapy allows secondary surgical resection in 10 to 20% of patients. Hepatic intra-arterial treatments could enhance response and resection rate. We therefore designed a prospective phase II trial testing the transarterial chemoembolization (TACE) using drug-eluting beads loaded with irinotecan (DEBIRI) with concomitant systemic FOLFOX regimen, the FFCD 1201 trial, in patients with liver limited metastatic CRC...
December 2015: Clinics and Research in Hepatology and Gastroenterology
Giammaria Fiorentini, Camillo Aliberti, Donatella Sarti, Paolo Coschiera, Massimo Tilli, Luca Mulazzani, Paolo Giordani, Francesco Graziano, Alfonso Marqués Gonzalez, Raul García Marcos, Fernando Gómez Mugnoz, Maurizio Cantore, Stefano Ricci, Vincenzo Catalano, Andrea Mambrini
AIM: To investigate efficacy and safety of second-line treatment with irinotecan-loaded drug-eluting beads (DEBIRI) and cetuximab (DEBIRITUX) of unresectable colorectal liver metastases. METHODS: Patients with the following characteristics were included in the study: unresectable hepatic metastases from colorectal carcinoma (CRC-LM), progression after first line chemotherapy (any type of chemotherapeutic drug and combination was allowed), second line treatment (mandatory), which included for each patient (unregarding the KRas status) two cycles of DEBIRI (using 100-300 μm beads loaded with irinotecan at a total dose 200 mg) followed by 12 cycles of cetuximab that was administered weekly at a first dose of 400 mg/m(2) and then 250 mg/m(2); good performance status (0-2) and liver functionality (alanine aminotransferase and gamma-glutamyl transferase not exceeding three times the upper limit of normal, total bilirubin not exceeding 2...
June 15, 2015: World Journal of Gastrointestinal Oncology
Roberto Bini, Simone Comelli, Alfredo Addeo, Tiziana Viora, Federica Vana, Giacomo Paolo Vaudano, Daniele Savio, Renzo Leli
Patients with advanced and incurable colorectal cancer have a very poor prognosis. Curative-intent resection was performed in 70%-90% of cases in reported series of colorectal cancer, sometimes after neoadjuvant chemotherapy and radiotherapy. The remaining 10%-30% of patients are treated with palliative intent, where treatment is aimed at relieving disease-related symptoms and improving quality of life. The provision of palliative care for these patients is complicated and outcomes are often disappointing. Although there are many available options including a variety of surgical and nonsurgical interventions, the best management remains controversial...
June 25, 2015: Tumori
Ulrik Carling, Eric J Dorenberg, Sven-Petter Haugvik, Nils Andreas Eide, Dag Tallak Berntzen, Bjørn Edwin, Svein Dueland, Bård Røsok
PURPOSE: The purpose of this study was to evaluate treatment response and complications of transarterial chemoembolization using drug-eluting beads loaded with irinotecan (DEBIRI) in patients with liver metastases from uveal melanoma (UM). MATERIALS AND METHODS: Patients treated with DEBIRI (n = 14) were retrospectively analyzed regarding overall survival, compared to patients (n = 14) treated with intravenous dacarbazine (DTIC). Median overall survival was calculated from time of diagnosis of metastatic disease (OS1) and start of treatment (OS2)...
December 2015: Cardiovascular and Interventional Radiology
M Stutz, A Mamo, D Valenti, A Hausvater, T Cabrera, P Metrakos, P Chaudhury, G Steacy, E Garoufalis, P Kavan
Background. Transarterial chemoembolization (TACE) has been investigated in patients with liver metastases from colorectal cancer (LMCRC). Limited experience and available data suggest that TACE can achieve disease stabilization or improvement, even in heavily pretreated patients. Methods. Patients with LMCRC, ECOG 0-2, who failed at least 1 line of systemic chemotherapy, received embolizations with 2 mL of microspheres preloaded with 100 mg of irinotecan. Beads were delivered selectively into hepatic arteries...
2015: Gastroenterology Research and Practice
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