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Hepatic arterial infusion chemotherapy

Joseph R Kallini, Ahmed Gabr, Nadine Abouchaleh, Rehan Ali, Ahsun Riaz, Robert J Lewandowski, Riad Salem
Colorectal cancer is the third leading cause of cancer death in the United States. Although hepatic excision is the first-line treatment for colorectal liver metastasis (CRLM), few patients are candidates. Locoregional therapy (LRT) encompasses minimally invasive techniques practiced by interventional radiology. These include ablative treatments (radiofrequency ablation, microwave ablation, and cryosurgical ablation) and transcatheter intra-arterial therapy (hepatic arterial infusion chemotherapy, transarterial "bland" embolization, transarterial chemoembolization, and radioembolization with yttrium 90)...
November 2016: Cancer Journal
Xiaodong Wang, Jungang Hu, Guang Cao, Xu Zhu, Yong Cui, Xinqiang Ji, Xuan Li, Renjie Yang, Hui Chen, Haifeng Xu, Peng Liu, Jian Li, Jie Li, Chunyi Hao, Baocai Xing, Lin Shen
Purpose To evaluate the efficacy and safety of hepatic arterial infusion (HAI) of oxaliplatin and 5-fluorouracil for advanced perihilar cholangiocarcinoma (PCC) in this prospective phase II study. Materials and Methods The protocol was approved by the local ethics committee, and all patients gave informed consent. Patients with nonresectable PCC were included in a prospective, open phase II study investigating HAI through interventionally implanted port catheters. HAI consisted of infusions of oxaliplatin 40 mg/m(2) for 2 hours, followed by 5-fluorouracil 800 mg/m(2) for 22 hours on days 1-3 every 3-4 weeks...
November 7, 2016: Radiology
Mohamed Bouchahda, Valérie Boige, Denis Smith, Abdoulaye Karaboué, Michel Ducreux, Mohamed Hebbar, Céline Lepère, Christian Focan, Rosine Guimbaud, Pasquale Innominato, Sameh Awad, Carlos Carvalho, Salvatore Tumolo, Stephanie Truant, Thierry De Baere, Denis Castaing, Philippe Rougier, Jean-François Morère, Julien Taieb, René Adam, Francis Lévi
BACKGROUND: Early tumour shrinkage has been associated with improved survival in patients receiving cetuximab-based systemic chemotherapy for liver metastases from colorectal cancer (LM-CRC). We tested this hypothesis for previously treated LM-CRC patients receiving cetuximab (500 mg/m(2)) and triplet hepatic artery infusion (HAI) within European trial OPTILIV. METHODS: Irinotecan (180 mg/m(2)), 5-fluorouracil (2800 mg/m(2)) and oxaliplatin (85 mg/m(2)) were given as chronomodulated or conventional delivery...
October 17, 2016: European Journal of Cancer
Masatoshi Kudo
Hepatocellular carcinoma (HCC) is the fifth most common cancer and the third leading cause of cancer deaths worldwide. Sonazoid-enhanced ultrasound and gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced MRI are the most important imaging modalities in diagnosing HCC. There are 2 non-contradictory HCC treatment algorithms in Japan. Hepatic arterial infusion chemotherapy plays an important role in the treatment of advanced HCC with main or branch portal vein invasion. Regorafenib, as a second-line systemic treatment, prolongs survival in patients with intermediate and advanced HCC who progressed on sorafenib...
2016: Digestive Diseases
Benjamin Sueur, Olivier Pellerin, Thibault Voron, Anne L Pointet, Julien Taieb, Simon Pernot
The objective of the treatment of colorectal cancer patients with unresectable liver metastases should be clearly defined at the outset. Potentially resectable patients should be distinguished from clearly unresectable patients. In defining resectability, it is important to take into account both anatomic characteristics and patient characteristic (comorbidities, symptoms, age). According to this evaluation, treatment should be tailored to each patient. The most widely accepted standard is doublet cytotoxic regimen plus biotherapy (anti-EGFR or anti- VEGF antibodies according to RAS status, but some patients could benefit from an intensified regimen, as triplet chemotherapy +/- bevacizumab, or intraarterial treatments (hepatic arterial infusion, radioembolization or chemoembolization), in order to allow resectability...
October 12, 2016: Minerva Chirurgica
Yao Wang, Xin Rong Sun, Wen Ming Feng, Ying Bao, Yin Yuan Zheng
BACKGROUND: Radical resection is the main treatment for colorectal cancer (CRC), but metastasis or recurrence is common in which liver metastasis accounted for 83% of the cases. Therefore, the prognosis of patients with advanced CRC may be improved if liver metastasis is prevented. This study aims to investigate the efficacy of hepatic arterial infusion chemotherapy (HAIC) on liver metastases of stage III CRC patients after curative resection. METHODS: Between 2002 and 2008, 287 stage III CRC patients who had undergone radical resection were included in this study...
2016: OncoTargets and Therapy
Atene Itoh, Hiroshi Sadamori, Kazuhisa Yabushita, Kazuteru Monden, Masashi Tatsukawa, Masayoshi Hioki, Tsuyoshi Hyodo, Kunihiro Omonishi, Toru Ueki, Satoshi Ohno, Kohsaku Sakaguchi, Norihisa Takakura
BACKGROUND: Hepatocellular carcinoma (HCC) patients with hepatic vein tumor thrombosis (HVTT) extending to the inferior vena cava (IVC) have an extremely poor prognosis. Here we report a case of HCC with HVTT and renal dysfunction after hepatic arterial infusion chemotherapy (HAIC) successfully treated by liver resection and active veno-venous bypass. CASE PRESENTATION: A 77-year-old man was diagnosed to have a large HCC with intrahepatic metastases and HVTT extending to the IVC...
2016: BMC Cancer
M Ikeda, S Shimizu, T Sato, M Morimoto, Y Kojima, Y Inaba, A Hagihara, M Kudo, S Nakamori, S Kaneko, R Sugimoto, T Tahara, T Ohmura, K Yasui, K Sato, H Ishii, J Furuse, T Okusaka
BACKGROUND: Sorafenib (Sor) is acknowledged as a standard therapy for advanced hepatocellular carcinoma (HCC). This trial was conducted to evaluate the effect of addition of hepatic arterial infusion chemotherapy with cisplatin (SorCDDP) to Sor for the treatment of advanced HCC. PATIENTS AND METHODS: We conducted a multicenter open-labeled randomized phase II trial in chemo-naïve patients with advanced HCC with Child-Pugh scores of 5-7. Eligible patients were randomly assigned 2:1 to receive SorCDDP (sorafenib: 400 mg bid; cisplatin: 65 mg/m(2), day 1, every 4-6 weeks) or Sor (400 mg bid)...
August 29, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
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
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)...
August 26, 2016: Journal of Surgical Oncology
Mashaal Dhir, Mazen S Zenati, James C Padussis, Heather L Jones, Samantha Perkins, Amber K Clifford, Jennifer Steve, Melissa E Hogg, Haroon A Choudry, Matthew P Holtzman, Herbert J Zeh, James F Pingpank, David L Bartlett, Amer H Zureikat
BACKGROUND: Hepatic artery infusion (HAI) chemotherapy can be combined with systemic chemotherapy for the treatment of isolated unresectable colorectal liver metastases (IU-CRLM) and intrahepatic cholangiocarcinoma (U-ICC). However, HAI pump placement requires a major laparotomy that may be associated with morbidity. We hypothesized that the computer-assisted robotic platform would be well suited for this procedure and report the first single institutional case series of robotic assisted HAI pump placement for primary and secondary malignancies of the liver...
September 2016: Journal of Surgical Oncology
Takeshi Hatanaka, Satoru Kakizaki, Yasushi Shimada, Daichi Takizawa, Kenji Katakai, Yuichi Yamazaki, Ken Sato, Motoyasu Kusano, Masanobu Yamada
Objective We retrospectively investigated the relationship between the tumor response and serial changes in α-fetoprotein (AFP) and des-γ-carboxy prothrombin (DCP) during hepatic arterial infusion of a cisplatin powder formulation (CDDP powder) in patients with advanced hepatocellular carcinoma (HCC). Methods Seventy-six advanced HCC patients were analyzed. All HCC patients received high-concentration cisplatin (1.43 mg/mL) via the haptic artery at a dose of 65 mg/m(2). AFP and DCP were measured at baseline and four to eight weeks after treatment, and the antitumor responses were evaluated according to the response evaluation criteria in solid tumours (RECIST) criteria after one or two courses of treatment...
2016: Internal Medicine
Eleonora M de Leede, Mark C Burgmans, Christian H Martini, Fred G J Tijl, Arian R van Erkel, Jaap Vuyk, Ellen Kapiteijn, Cornelis Verhoef, Cornelis J H van de Velde, Alexander L Vahrmeijer
Unresectable liver metastases of colorectal cancer can be treated with systemic chemotherapy, aiming to limit the disease, extend survival or turn unresectable metastases into resectable ones. Some patients however, suffer from side effects or progression under systemic treatment. For patients with metastasized uveal melanoma there are no standard systemic therapy options. For patients without extrahepatic disease, isolated liver perfusion (IHP) may enable local disease control with limited systemic side effects...
2016: Journal of Visualized Experiments: JoVE
Mashaal Dhir, Deepa Magge, Stephanie Novak, David L Bartlett, Amer H Zureikat
BACKGROUND: Hepatic artery infusion (HAI) chemotherapy is an effective regional therapy for unresectable colorectal liver metastases (U-CRLM).1 (,) 2 One of its limitations is the need for a laparotomy, which can delay the use of systemic therapy.3 Here, we describe a purely robotic technique for placement of an HAI pump (Fig 1). PATIENT: A 62-year-old male presented with a symptomatic ascending colon cancer and multiple bilobar unresectable liver metastases. He underwent laparoscopic right colectomy followed by six cycles of FOLFOXIRI and bevacizumab with stable disease by RECIST (Response Evaluation Criteria in Solid Tumors) criteria, and also underwent robotic HAI pump placement...
August 5, 2016: Annals of Surgical Oncology
Masatoshi Kudo, Namiki Izumi, Michiie Sakamoto, Yutaka Matsuyama, Takafumi Ichida, Osamu Nakashima, Osamu Matsui, Yonson Ku, Norihiro Kokudo, Masatoshi Makuuchi
BACKGROUND: Beginning in 1967, the Liver Cancer Study Group of Japan (LCSGJ) started a nationwide prospective registry of all patients with hepatocellular carcinoma (HCC) diagnosed at more than 700 institutions. To determine the effectiveness of surveillance and treatment methods longitudinally, we analyzed improvements over time in overall survival (OS) of 173,378 patients with HCC prospectively entered into the LCSGJ registry between 1978 and 2005. METHODS: All patients from more than 700 institutions throughout Japan with HCC were entered into the LCSGJ registry...
July 2016: Liver Cancer
Hee Chul Park, Jeong Il Yu, Jason Chia-Hsien Cheng, Zhao Chong Zeng, Ji Hong Hong, Michael Lian Chek Wang, Mi Sook Kim, Kwan Hwa Chi, Po-Ching Liang, Rheun-Chuan Lee, Wan-Yee Lau, Kwang Hyub Han, Pierce Kah-Hoe Chow, Jinsil Seong
A consensus meeting to develop practice guidelines and to recommend future clinical trials for radiation therapy (RT), including external beam RT (EBRT), and selective internal RT (SIRT) in hepatocellular carcinoma (HCC) was held at the 5th annual meeting of the Asia-Pacific Primary Liver Cancer Expert consortium. Although there is no randomized phase III trial evidence, the efficacy and safety of RT in HCC has been shown by prospective and retrospective studies using modern RT techniques. Based on these results, the committee came to a consensus on the utility and efficacy of RT in the management of HCC according to each disease stage as follows: in early and intermediate stage HCC, if standard treatment is not compatible, RT, including EBRT and SIRT can be considered...
July 2016: Liver Cancer
Mashaal Dhir, Heather L Jones, Yongli Shuai, Amber K Clifford, Samantha Perkins, Jennifer Steve, Melissa E Hogg, M Haroon A Choudry, James F Pingpank, Matthew P Holtzman, Herbert J Zeh, Nathan Bahary, David L Bartlett, Amer H Zureikat
BACKGROUND: In the era of effective modern systemic chemotherapy (CT), the role of hepatic arterial infusion of fluoxuridine (HAI-FUDR) in the treatment of isolated unresectable colorectal liver metastasis (IU-CRCLM) remains controversial. This study aimed to compare the overall survival (OS) of HAI-FUDR in combination with modern systemic CT versus modern systemic CT alone in patients with IU-CRCLM. METHODS: This was a case-control study of IU-CRCLM patients who underwent HAI + modern systemic CT or modern systemic CT alone...
July 18, 2016: Annals of Surgical Oncology
Seiji Tsunematsu, Goki Suda, Kazushi Yamasaki, Megumi Kimura, Takaaki Izumi, Machiko Umemura, Jun Ito, Fumiyuki Sato, Masato Nakai, Takuya Sho, Kenichi Morikawa, Koji Ogawa, Toshiya Kamiyama, Akinobu Taketomi, Naoya Sakamoto
AIM: Hepatic arterial infusion chemotherapy (HAIC) is a potent therapeutic option for advanced hepatocellular carcinoma (HCC). However, there are few known predictive factors of treatment response to HAIC. We clarified the most accurate predictive factors early on in treatment. METHODS: Study subjects were 70 patients with advanced HCC who had been treated with HAIC. We assessed the relationships between patient characteristics, change ratios of early tumor markers, tumor response, progression-free survival (PFS), and overall survival...
July 16, 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Dai Hoon Han, Dong Jin Joo, Myoung Soo Kim, Gi Hong Choi, Jin Sub Choi, Young Nyun Park, Jinsil Seong, Kwang Hyub Han, Soon Il Kim
Locally advanced hepatocellular carcinoma (HCC) with portal vein thrombosis carries a 1-year survival rate <10%. Localized concurrent chemoradiotherapy (CCRT), followed by hepatic arterial infusion chemotherapy (HAIC), was recently introduced in this setting. Here, we report our early experience with living donor liver transplantation (LDLT) in such patients after successful down-staging of HCC through CCRT and HAIC. Between December 2011 and September 2012, eight patients with locally advanced HCC at initial diagnosis were given CCRT, followed by HAIC, and underwent LDLT at the Severance Hospital, Seoul, Korea...
September 2016: Yonsei Medical Journal
Francis Lévi, Abdoulaye Karaboué, Marie-Christine Etienne-Grimaldi, Gilles Paintaud, Christian Focan, Pasquale Innominato, Mohamed Bouchahda, Gérard Milano, Etienne Chatelut
The combination of hepatic artery infusion (HAI) of irinotecan, 5-fluorouracil and oxaliplatin with intravenous cetuximab has safely achieved prolonged survival in colorectal cancer patients with extensive liver metastases and prior treatment. Systemic exposure to the drugs or their main metabolites was determined during the first course of chronomodulated triplet HAI in 11 patients and related to toxicities after one or three courses. Consistent trends were found between the area under the plasma concentration-time curve (AUC) values of irinotecan, 7-ethyl-10-hydroxycamptothecin (SN38; a bioactive metabolite), total oxaliplatin and platinum ultrafiltrate (P-UF), on the one hand, and subsequent leukopenia severity, on the other hand...
July 8, 2016: Clinical Pharmacokinetics
Masahiro Hatooka, Tomokazu Kawaoka, Hiroshi Aikata, Kei Morio, Tomoki Kobayashi, Akira Hiramatsu, Michio Imamura, Yoshiiku Kawakami, Eisuke Murakami, Koji Waki, Yoji Honda, Nami Mori, Shintaro Takaki, Keiji Tsuji, Hirotaka Kohno, Hiroshi Kohno, Takashi Moriya, Michihiro Nonaka, Hideyuki Hyogo, Yasuyuki Aisaka, Kazuaki Chayama
AIM: To compare the outcome of 5-fluorouracil (FU)-based hepatic arterial infusion chemotherapy (HAIC) with sorafenib monotherapy in patients with hepatocellular carcinoma (HCC) refractory to transcatheter arterial chemoembolization (TACE). PATIENTS AND METHODS: In this retrospective cohort study, 123 patients with HCC refractory to TACE, with Child-Pugh A and free of extrahepatic metastasis, were divided into two groups: 65 received HAIC and 58 received sorafenib...
July 2016: Anticancer Research
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