title: Target hepatic artery regional chemotherapy and bevacizumab perfusion in liver metastatic colorectal cancer after failure of first-line or second-line systemic chemotherapy.
abstract: Colorectal cancer liver metastasis (CRLM) is a refractory disease after failure of first-line or second-line chemotherapy. Bevacizumab is recommended as first-line therapy for advanced colorectal cancer, but is unproven in CRLM through the hepatic artery. We report favorable outcomes with targeted vessel regional chemotherapy (TVRC) for liver metastatic gastric cancer. TVRC with FOLFOX and bevacizumab perfusion through the hepatic artery was attempted for CRLM for efficacy and safety evaluation. In a single-institution retrospective observational study, 246 patients with CRLM after at least first-line or second-line failure of systemic chemotherapy received TVRC with FOLFOX (i.e. oxaliplatin, leucovorin, and 5-fluorouracil). Of 246 patients, 63 were enrolled into two groups: group 1 (n=30) received bevacizumab and TVRC following tumor progression during previous TVRC treatments; group 2 (n=33) received TVRC plus bevacizumab for CRLM on initiating TVRC. There were no significant differences in the median survival time (14.7 vs. 13.2 months, P=0.367), although the median time to progression was significant (3.3 vs. 5.5 months, P=0.026) between groups. No severe adverse events related to TVRC plus bevacizumab perfusion occurred. Target vessel regional chemotherapy with FOLFOX plus bevacizumab perfusion through the hepatic artery was effective and safe in CRLM. The optimal combination of TVRC and bevacizumab needs further confirmation in future phase II-III clinical trials.
authors.affiliation: aKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Interventional Therapy bDepartment of Gastrointestinal Surgery, Peking University Cancer Hospital, Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
authors.forename: Ji
authors.initials: J
authors.lastname: Zhang
authors.forename: Guang
authors.initials: G
authors.lastname: Cao
authors.forename: Peng
authors.initials: P
authors.lastname: Liu
authors.forename: Haifeng
authors.initials: H
authors.lastname: Xu
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Wang
authors.forename: Xu
authors.initials: X
authors.lastname: Zhu
authors.forename: Song
authors.initials: S
authors.lastname: Gao
authors.forename: Jianhai
authors.initials: J
authors.lastname: Guo
authors.forename: Linzhong
authors.initials: L
authors.lastname: Zhu
authors.forename: Pengjun
authors.initials: P
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000068258:Bevacizumab / Q000008:administration & dosage*; D010478:Chemotherapy, Cancer, Regional Perfusion; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D020533:Angiogenesis Inhibitors; D000068258:Bevacizumab