title: A review of conventional and drug-eluting chemoembolization in the treatment of colorectal liver metastases: principles and proof.
abstract: The management of colorectal liver metastasis has undergone a significant change since the development of novel ablation and embolization. Drug-eluting microsphere platforms, designed to deliver targeted concentrations of systemic therapy directly into the tumor via its arterial vasculature, have garnered interest and gained in popularity in recent years. Based on in vitro and in vivo data, multiple factors contribute to locoregional exposure including carrier base, smaller particle size (larger surface area), chemotherapeutic and chemotherapeutic intensity. Based on the current published clinical data, therapy appears well tolerated but the questions remain as to the ideal technique, patient population and overall efficacy. The purpose of this article is to provide a perspective on the scientific basis, and clinical review of the current data supporting the use of this platform in the setting of metastatic colorectal carcinoma.
authors.affiliation: Department of Interventional Radiology, Vancouver General Hospital, Vancouver BC, Canada.
authors.forename: David M
authors.initials: DM
authors.lastname: Liu
authors.forename: Avnesh S
authors.initials: AS
authors.lastname: Thakor
authors.forename: Mark
authors.initials: M
authors.lastname: Baerlocher
authors.forename: Mohammed T
authors.initials: MT
authors.lastname: Alshammari
authors.forename: Howard
authors.initials: H
authors.lastname: Lim
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kos
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Kennedy
authors.forename: Harpreet
authors.initials: H
authors.lastname: Wasan
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage*; D016461:Chemoembolization, Therapeutic / Q000379:methods; D002986:Clinical Trials as Topic; D015179:Colorectal Neoplasms / Q000473:pathology*; D004337:Drug Carriers; D016503:Drug Delivery Systems; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D004337:Drug Carriers
keywords: DEBIRI; colon cancer metastasis; colorectal liver metastasis; drug-eluting bead; embolization; interventional radiology; irinotecan drug-eluting beads; liver-directed therapy