title: Intra-arterial therapies for colorectal cancer liver metastases (radioembolization excluded).
abstract: During the past 20 years, advances in systemic therapies have improved overall survival of patients with Colorectal cancer Liver metastases (CRLM) from 6 to 24 months. By reaching CRLM via their preferential arterial vascularization, hepatic arterial infusion of chemotherapy (HAIC) has demonstrated improvement in response rate and deepness of response. Improvement in deepness of response is potentially helpful to convert no surgical patient to surgery. Recent HAIC regimens, including HAIC-FUDR plus systemic oxaliplatin/irinotecan, or HAIC-oxaliplatin plus systemic 5FU and cetuximab yielded a 92% and 90% response rate respectively, and conversion to R0 surgery in 47% and 42% of patients, respectively. When HAIC delivered a drug ineffective through intravenous delivery, this rechallenge provided 62% response rate for HAIC. Nowadays, port-catheter implanted percutaneously by radiologists has 95% feasibility with primary patency equivalent to that of surgically implanted catheters, and secondary patency superior after radiologic revision. Retrospective studies demonstrated prolonged DFS of HAIC over IV chemotherapy in the adjuvant setting after surgery of CRLM. Drug eluting beads loaded with irinotecan (DEBIRI) were developed as drug carrier and embolization platform for treatment of CRLM by chemoembolization. DEBIRI allows for a very high level of SN-38 (SN-38 is the active compound of irinotecan) and a very high rate of complete l response at pathologic studies of treated metastases. DEBIRI was compared to systemic FOLFIRI in a phase III randomized trial including 74 patients with benefit in overall survival and disease-free survival.
authors.affiliation: Gustave-Roussy Cancer Center, Department of Interventional Radiology, 114, rue Edouard-Vaillant, 94805 Villejuif, France; Université Paris-Sud XI, UFR Médecine, 94270 Le Kremlin-Bicêtre, France. Electronic address: thierry.debaere@gustaveroussy.fr.
authors.forename: Thierry
authors.initials: T
authors.lastname: de Baere
authors.affiliation: Gustave-Roussy Cancer Center, Department of Interventional Radiology, 114, rue Edouard-Vaillant, 94805 Villejuif, France; Université Paris-Sud XI, UFR Médecine, 94270 Le Kremlin-Bicêtre, France.
authors.forename: Lambros
authors.initials: L
authors.lastname: Tselikas
authors.affiliation: Gustave-Roussy Cancer Center, Department of Interventional Radiology, 114, rue Edouard-Vaillant, 94805 Villejuif, France; Université Paris-Sud XI, UFR Médecine, 94270 Le Kremlin-Bicêtre, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Boige
authors.affiliation: Gustave-Roussy Cancer Center, Department of Interventional Radiology, 114, rue Edouard-Vaillant, 94805 Villejuif, France; Université Paris-Sud XI, UFR Médecine, 94270 Le Kremlin-Bicêtre, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Ducreux
authors.affiliation: Gustave-Roussy Cancer Center, Department of Interventional Radiology, 114, rue Edouard-Vaillant, 94805 Villejuif, France; Université Paris-Sud XI, UFR Médecine, 94270 Le Kremlin-Bicêtre, France.
authors.forename: David
authors.initials: D
authors.lastname: Malka
authors.affiliation: Gustave-Roussy Cancer Center, Department of Interventional Radiology, 114, rue Edouard-Vaillant, 94805 Villejuif, France; Université Paris-Sud XI, UFR Médecine, 94270 Le Kremlin-Bicêtre, France.
authors.forename: Diane
authors.initials: D
authors.lastname: Goéré
authors.affiliation: Gustave-Roussy Cancer Center, Department of Interventional Radiology, 114, rue Edouard-Vaillant, 94805 Villejuif, France; Université Paris-Sud XI, UFR Médecine, 94270 Le Kremlin-Bicêtre, France.
authors.forename: Eléonore
authors.initials: E
authors.lastname: Benahim
authors.affiliation: Gustave-Roussy Cancer Center, Department of Interventional Radiology, 114, rue Edouard-Vaillant, 94805 Villejuif, France; Université Paris-Sud XI, UFR Médecine, 94270 Le Kremlin-Bicêtre, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Deschamps
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D002404:Catheterization / Q000379:methods; D015179:Colorectal Neoplasms / Q000473:pathology*; D004337:Drug Carriers; D005472:Fluorouracil / Q000008:administration & dosage; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods*; D000077146:Irinotecan; D002955:Leucovorin / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000556:secondary*; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin
chemical_list: D004337:Drug Carriers; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000077146:Irinotecan; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin
keywords: Colorectal cancer; Hepatic arterial infusion chemotherapy; Liver metastases; Local treatment; Transarterial chemoembolization