Salvage regional therapy using hepatic artery infusion pump in unresectable chemotherapy resistant colorectal liver metastases

Little is known about the influence of hepatic artery infusion pump (HAIP) therapy in the setting of chemotherapy resistant hepatic disease in the era of modern systemic therapies. Patients who underwent HAIP therapy for chemotherapy resistant and unresectable colorectal liver metastases (CRLM) were...

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Bibliographic Details
Published in:The American journal of surgery 2022-06, Vol.223 (6), p.1151-1156
Main Authors: O'Leary, Michael P., Wang, Chongkai, Sandhu, Jaideep, Malhotra, Gautam K., Thornblade, Lucas W., Lau, Cecilia, Melstrom, Laleh G., Fong, Yuman, Singh, Gagandeep, Fakih, Marwan G.
Format: Article
Language:English
Subjects:
Ablation
Cancer therapies
Chemotherapy
Colon cancer
Colorectal cancer
Colorectal carcinoma
Drug therapy
Embolization
FUDR
Hepatic arterial infusion
Hepatic artery
Infusion pumps
Laboratories
Liver
Liver cancer
Liver diseases
Metastases
Metastasis
Patients
Phosphatase
Radiation therapy
Survival
Tumors
Ulcers
Veins & arteries
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Summary:Little is known about the influence of hepatic artery infusion pump (HAIP) therapy in the setting of chemotherapy resistant hepatic disease in the era of modern systemic therapies. Patients who underwent HAIP therapy for chemotherapy resistant and unresectable colorectal liver metastases (CRLM) were reviewed retrospectively. A total of 25 patients met inclusion criteria. 52% had isolated CRLM and 92% had five or more metastatic lesions. Partial response was noted in 40% of patients. Median hepatic progression-free survival (PFS) was 7 months in those with extrahepatic disease versus 6 months in those with isolated CRLM at the time of HAIP placement (p = 0.75). Median overall survival was 8 months in patients with extrahepatic disease and 14 months in patients with isolated CRLM (p = 0.06). Our findings are comparable to published data and augment the literature which supports HAIP use in chemotherapy-resistant, liver-predominant metastatic colorectal cancer patients. •Patients with unresectable hepatic metastatic disease who have failed standard chemotherapy, have limited options.•Our study showed a 6-month median PFS and a PR rate of 40% to HAIP in patients with CRLM-predominant disease.•Clinical benefits were noted in patients with both liver-limited disease and liver and small volume extrahepatic disease.•HAIP should be considered in liver-predominant chemotherapy-resistant colorectal cancer as a salvage modality.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2021.10.032