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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...
August 10, 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
OBJECTIVES: Aim of our preliminary study was to compare the efficacy of DEBIRI vs. DEBDOX as second line treatment of unresectable liver metastases from cholangiocarcinoma. METHODS: In 2013, 10 patients affected by multiple liver metastases from cholangiocarcinoma, resistant to the first line chemotherapy regimen, were enrolled: 5 were submitted to lobar/segmental TACE with DEBIRI (100mg Irinotecan/1vial) and 5 with DEBDOX (50mg Doxorubicin/1vial), performed every 3 weeks...
August 25, 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...
June 10, 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...
May 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
Roberto Iezzi, Valentina Angela Marsico, Alessandra Guerra, Eleonora Cerchiaro, Alessandra Cassano, Michele Basso, Ersilia Devicienti, Elena Rodolfino, Carlo Barone, Lorenzo Bonomo
PURPOSE: The purpose of this study was to evaluate feasibility, safety, tolerance, and efficacy of drug-eluting beads loaded with irinotecan (DEBIRI) in combination with capecitabine in the treatment of mCRC refractory to chemotherapy in patients affected by liver predominant metastatic disease. MATERIALS AND METHODS: Twenty patients affected by CRC hepatic metastasis with liver-dominant disease, who had progression after two or more lines of chemotherapy, were enrolled...
December 2015: Cardiovascular and Interventional Radiology
Olaguoke Akinwande, Amanda Miller, David Hayes, Ryan O'Hara, Dana Tomalty, Robert C G Martin
BACKGROUND: Effectiveness and toxicity of transcatheter arterial injection of irinotecan-eluting beads (DEBIRI) with and without concurrent capecitabine in pre-treated patients with metastatic colorectal cancer (CRC). PATIENTS AND METHODS: An Institutional Review Board-approved, multi-institutional registry from 5/2008 to 8/2013 was reviewed. Patients who received DEBIRI with (X-DEBIRI) or without (DEBIRI) capecitabine were compared. RESULTS: Twenty-two X-DEBIRI and 149 DEBIRI patients were compared...
December 2014: Anticancer Research
Olaguoke K Akinwande, Prejesh Philips, Petr Duras, Stefan Pluntke, Charles Scoggins, Robert C G Martin
PURPOSE: To compare the feasibility, safety, and efficacy with small and large irinotecan drug-eluting beads (DEBIRI) for treating hepatic colorectal metastases. METHODS: Using our prospectively maintained, multi-center, intra-arterial therapy registry, we identified 196 patients treated with a combination of large beads (100-300 to 500-700 μm) and patients treated with a combination of small beads (70-150 to 100-300 μm). To minimize selection bias, a propensity score analysis was performed to compare both groups...
April 2015: Cardiovascular and Interventional Radiology
Domina Kekez, Sasa Badzek, Juraj Prejac, Irma Gorsic, Hilda Golem, Niksa Librenjak, Drazen Perkov, Ranko Smiljanic, Stjepko Plestina
AIM: Safety evaluation of concomitant systemic chemotherapy and liver chemoembolization in patients with colorectal cancer. PATIENTS AND METHODS: Seven patients with metastases confined to the liver were included and stratified into two groups, depending of dosage of systemic chemotherapy. The first group received systemic chemotherapy (FOLFIRI) with 20% dose reduction, and the second group received the full dose of the same chemotherapy. In both groups, chemoembolization of liver metastases with drug-eluting bead irinotecan (DEBIRI) was performed following the application of systemic chemotherapy...
September 2014: Tumori
Joseph E Cruz, Rujuta Saksena, Salma K Jabbour, John L Nosher, Evelyn Hermes-DeSantis, Rebecca A Moss
OBJECTIVE: To report a case of systemic irinotecan toxicity following regional transarterial chemoembolization with drug-eluting beads loaded with irinotecan (DEBIRI-TACE) in a patient later found to have a homozygous mutation for UGT1A1*28. CASE SUMMARY: An 80-year-old woman presented with a cecal colon cancer with synchronous metastases to the liver. After resection of the primary tumor, the patient underwent DEBIRI-TACE with 100 mg of irinotecan to treat the residual disease in the liver...
December 2014: Annals of Pharmacotherapy
Riccardo Lencioni, Camillo Aliberti, Thierry de Baere, Ricardo Garcia-Monaco, Govindarajan Narayanan, Elizabeth O'Grady, William S Rilling, Duncan Walker, Robert C G Martin
Transcatheter hepatic arterial administration of irinotecan-loaded drug-eluting beads (DEBIRI) is used to treat liver-only or liver-dominant metastatic disease from colorectal cancer (CRC). Eligibility for DEBIRI should be established in each individual patient by a multidisciplinary team based on comprehensive clinical, imaging, and laboratory assessment. Standardization of DEBIRI technique and protocols would be expected to lead to improved efficacy and safety. The present article provides a set of technical recommendations for the use of DEBIRI in the treatment of hepatic CRC metastases...
March 2014: Journal of Vascular and Interventional Radiology: JVIR
R P Jones, S Stättner, D F J Dunne, E O'Grady, A Smethurst, M Terlizzo, H Z Malik, S W Fenwick, G J Poston
INTRODUCTION: Transcatheter hepatic therapy with irinotecan-eluting beads (DEBIRI(®)) allows targeted delivery of irinotecan direct to liver tissue and colorectal liver metastases (CRLM). Accurate assessment of tumour response to therapy is vital to guide optimal treatment. Preliminary work has suggested existing criteria for radiological response may not reflect pathological response after neoadjuvant DEBIRI. This study assessed the relationship between existing and novel radiological response criteria and pathological tumour response as well as long-term outcome...
October 2013: European Journal of Surgical Oncology
Arthur J Richardson, Jerome M Laurence, Vincent W T Lam
PURPOSE: For patients with unresectable colorectal liver metastasis (CRLM), transarterial embolization with the use of drug-eluting beads with irinotecan (DEBIRI) represents a novel alternative to systemic chemotherapy or local treatments alone. The present systematic review evaluates available data on the efficacy and safety of DEBIRI embolization. MATERIALS AND METHODS: A comprehensive search of medical literature identified studies describing the use of DEBIRI in the treatment of CRLM...
August 2013: Journal of Vascular and Interventional Radiology: JVIR
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