Article: article from journal or magazin.
Hepatic arterial infusion of oxaliplatin and intravenous LV5FU2 in unresectable liver metastases from colorectal cancer after systemic chemotherapy failure
Ann Surg Oncol
1534-4681 (Electronic)1068-9265 (Linking)
Boige, ValerieMalka, DavidElias, DominiqueCastaing, MarineDe Baere, ThierryGoere, DianeDromain, ClarissePocard, MarcDucreux, MichelengResearch Support, Non-U.S. Gov't2007/09/27 09:00Ann Surg Oncol. 2008 Jan;15(1):219-26. Epub 2007 Sep 26.
BACKGROUND: We have previously shown promising activity of hepatic arterial infusion (HAI) oxaliplatin combined with intravenous (IV) 5-fluorouracil (5-FU) and leucovorin (LV) as first-line chemotherapy in patients with colorectal liver metastases (CRLM) (intent-to-treat [ITT] objective response rate [ORR], 64%; secondary resection rate, 18%; overall survival [OS], 27 months). Whether this regimen could be beneficial after systemic chemotherapy failure is unknown. METHODS: Patients with unresectable CRLM and history of systemic chemotherapy failure were treated bimonthly with HAI oxaliplatin (100 mg/m(2) 2 hours) combined with IV LV and IV bolus and infusional 5FU (modified LV5FU2 regimen). RESULTS: Forty-four consecutive patients (median age 56 years; median number of prior systemic chemotherapy regimens, 2 range 1-5) were included, of whom 43 (98%) had previously received oxaliplatin (n = 34), irinotecan (n = 37), or both (n = 28). Patients received a median of nine cycles of HAI oxaliplatin and IV modified LV5FU2 (range 0-25). Toxicity included grade 3-4 neutropenia (43%), grade 2-3 neuropathy (43%), and grade 3-4 abdominal pain (14%). We observed 24 partial ORs (62%) among the 39 assessable patients (ITT ORR, 55%; 95% CI, 40-69%), including 17, 12, and 12 patients who had failed to respond to prior systemic chemotherapy with FOLFIRI, FOLFOX, or both, respectively. Tumor response allowed further R0 surgical resection (n = 7) or radiofrequency ablation (n = 1) of initially unresectable CRLM in eight patients (18%). Median progression-free survival and OS were 7 and 16 months, respectively. CONCLUSIONS: HAI oxaliplatin and IV LV5FU2 is feasible, safe, and shows promising activity after systemic chemotherapy failure, allowing surgical resection of initially unresectable CRLM in 18% of patients.
Adult, Aged, Antineoplastic Combined Chemotherapy Protocols/*administration & dosage, Colorectal Neoplasms/*drug therapy/pathology, Feasibility Studies, Female, Fluorouracil/administration & dosage, Follow-Up Studies, *Hepatic Artery, Humans, Infusions, Intra-Arterial, Infusions, Intravenous, Leucovorin/administration & dosage, Liver Neoplasms/*drug therapy/secondary, Male, Middle Aged, Organoplatinum Compounds/administration & dosage, Prospective Studies, Survival Rate, Treatment Outcome
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