title: Limited potential of hepatic arterial infusion of irinotecan.
abstract: Intravenously administered irinotecan has gained an important place in the struggle against metastatic and/or irresectable colorectal cancer. In patients with irresectable metastases confined to the liver, hepatic arterial infusion (HAI) of this anti-cancer agent has considered to be an option. Partly based on conducted phase I- and II-studies, here we conclude that irinotecan as single agent HAI therapy has limited potential compared to intravenous administration. From a pharmacokinetic-pharmacodynamic point of view, in particular the long half-life of the active metabolite, SN-38, its use is limited as well. In our view, future clinical implementation of irinotecan as HAI chemotherapy is unrealistic.
authors.affiliation: Erasmus MC University Medical Center Rotterdam - Daniel den Hoed Cancer Center, Department of Medical Oncology, Rotterdam, The Netherlands. f.a.dejong@erasmusmc.nl
authors.forename: F A
authors.initials: FA
authors.lastname: De Jong
authors.forename: R H J
authors.initials: RH
authors.lastname: Mathijssen
authors.forename: J
authors.initials: J
authors.lastname: Verweij
mesh_terms: D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage*; D002166:Camptothecin / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000378:metabolism; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods*; D000077146:Irinotecan; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D000077146:Irinotecan; D002166:Camptothecin