title: Response rates of hepatic arterial infusion pump therapy in patients with metastatic colorectal cancer liver metastases refractory to all standard chemotherapies.
abstract: OBJECTIVE
  To evaluate the role of hepatic arterial infusion (HAI) in patients with metastatic colorectal cancer (mCRC) liver metastases (LM) refractory to oxaliplatin, irinotecan, and fluorouracil-based treatments.
  
  
  METHODS
  A search identified patients with mCRC treated after tumor progression on at least three standard systemic therapies.
  
  
  RESULTS
  One hundred and ten patients met criteria for inclusion (i.e., progression on at least three standard agents). Fifty seven patients had LM-only and 53 patients had LM and low volume extrahepatic metastases (LME). Patients with LM-only and LME had a response rate (RR) of 33% and 36%, median survival of 20 months and 11.4 months, respectively. Patients with LM-only had progression free survival of 6 months and hepatic progression free survival of 7.56 months. In a secondary analysis, 46 patients were RECIST-refractory to all standard therapies: LM-only (n = 24) and LME (n = 22). LM-only and LME had a RR of 29% and 36%, and median survival 17.2 months and 9.1 months, respectively.
  
  
  CONCLUSIONS
  Patients with refractory mCRC LM can achieve a response to HAI resulting in antitumor activity and improvement in survival. Responses are rarely seen in such heavily treated patients with systemic therapy alone, suggesting a regional directed approach is useful. J. Surg. Oncol. 2016;114:655-663. © 2016 Wiley Periodicals, Inc.
authors: Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. cerceka@mskcc.org.
authors: Andrea
authors: A
authors: Cercek
authors: Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
authors: Taryn M
authors: TM
authors: Boucher
authors: Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
authors: Jill S
authors: JS
authors: Gluskin
authors: Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
authors: Ariel
authors: A
authors: Aguiló
authors: Department of Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
authors: Joanne F
authors: JF
authors: Chou
authors: Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
authors: Louise C
authors: LC
authors: Connell
authors: Department of Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
authors: Marinela
authors: M
authors: Capanu
authors: Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
authors: Diane
authors: D
authors: Reidy-Lagunes
authors: Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors: Michael
authors: M
authors: D'Angelica
authors: Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
authors: Nancy E
authors: NE
authors: Kemeny
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000473:pathology*; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005467:Floxuridine / Q000008:administration & dosage / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D005467:Floxuridine; D003907:Dexamethasone
keywords: colorectal cancer; liver metastases; refractory; response rates; survival