Hepatic arterial infusion of oxaliplatin and L-folinic acid-modulated 5-fluorouracil for colorectal cancer liver metastases.
BACKGROUND
Despite the progress made in the treatment of metastatic colorectal cancer (CRC), the results of second-line chemotherapy remain poor.


METHODS
The feasibility of hepatic arterial infusion (HAI) of oxaliplatin (100 mg/m2 over 6 h) followed by l-folinic acid (L-FA) (400 mg over 2 h i.v.)-modulated continuous HAI of 5-Fluorouracil (5-FU) (60 mg/kg over 42 h; q2w) as second-line chemotherapy for metastatic CRC limited to the liver was investigated.


RESULTS
A median of 9 treatment cycles were administered (range 4-14). Treatment-limiting toxicity consisted of: abdominal pain (3 patients), elevated liver enzymes accompanied by fatigue (3), elevated bilirubin (2), neutropenia (2), thrombocytopenia (3) and hypersensitivity to oxaliplatin (1). Normalization for >4 weeks of the carcinoembryonic antigen (CEA) level was documented in 3 patients and a decline of >50% for >4 weeks in 5 patients. A confirmed partial response (PR) was documented in 5, stable disease (SD) in 1 and progressive disease (PD) in 3 patients. In the latter 3 patients, lung metastases developed while a PR was observed in the liver metastases. A pathological complete response (CR) was documented in 2 patients. The median time to progression was 7.2 months (95% CI 1.3-13) and the median overall survival 18.3 months (95% CI 16.3-20.3).


CONCLUSIONS
HAI of oxaliplatin plus CI5-FU/LV is feasible and merits further evaluation.
Neyns
Bart
B
Department of Medical Oncology, Oncologisch Centrum AZ-VUB, Brussels, Belgium. Bart.Neyns@az.vub.ac.be
Van Nieuwenhove
Yves
Y
Aerts
Maridi
M
Fontaine
Christel
C
Vermeij
Joanna
J
Schallier
Dennis
D
Decoster
Lore
L
De Mey
Johan
J
Vandenbroucke
Frederik
F
Hoorens
Anne
A
Delvaux
Georges
G
De Gréve
Jacques
J
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects; D008113:Liver Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D000077150:Oxaliplatin
D002272:Carcinoembryonic Antigen; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D002955:Leucovorin; D005472:Fluorouracil