Advanced search
Publication Cover
Expert Review of Anticancer Therapy Volume 16, 2016 - Issue 2
Submit an article Journal homepage
323
Views
3
CrossRef citations to date
0
Altmetric
Reviews

The state of regional therapy in the management of metastatic colorectal cancer to the liver

May ChoDepartment of Medical Oncology, City of Hope National Medical Center, Duarte, CA, USA
,
Jun GongDepartment of Medical Oncology, City of Hope National Medical Center, Duarte, CA, USA
&
Marwan FakihDepartment of Medical Oncology, City of Hope National Medical Center, Duarte, CA, USACorrespondence[email protected]
Pages 229-245 | Received 12 Oct 2015, Accepted 04 Dec 2015, Published online: 13 Jan 2016

References

  • Papers of special note have been highlighted as:
  • * of interest
  • ** of considerable interest
  • Siegel, R., et al. Cancer statistics, 2014. CA Cancer J Clin. 2014;64(1):9–29.
  • Fong, Y., et al. Liver resection for colorectal metastases. J Clin Oncol. 1997;15(3):938–946.
  • Weiss, L., et al. Haematogenous metastatic patterns in colonic carcinoma: an analysis of 1541 necropsies. J Pathol. 1986;150(3):195–203.
  • Beard, S.M., et al. Hepatic resection for colorectal liver metastases: a cost-effectiveness analysis. Ann Surg. 2000;232(6):763–776.
  • van Ooijen, B., et al. Hepatic resections for colorectal metastases in The Netherlands. A multiinstitutional 10-year study. Cancer. 1992;70(1):28–34.
  • Robertson, D.J., et al. Survival after hepatic resection of colorectal cancer metastases: a national experience. Cancer. 2009;115(4):752–759.
  • Adam, R., et al. Patients with initially unresectable colorectal liver metastases: is there a possibility of cure? J Clin Oncol. 2009;27(11):1829–1835.
  • Weng, M., et al. Radiofrequency ablation versus resection for colorectal cancer liver metastases: a meta-analysis. PLoS One. 2012;7(9):e45493.
  • Gillams AR, Lees WR. Five-year survival in 309 patients with colorectal liver metastases treated with radiofrequency ablation. Eur Radiol. 2009;19(5):1206–1213.
  • Chang, D.T., et al. Stereotactic body radiotherapy for colorectal liver metastases: a pooled analysis. Cancer. 2011;117(17):4060–4069.
  • Rusthoven, K.E., et al. Multi-institutional phase I/II trial of stereotactic body radiation therapy for liver metastases. J Clin Oncol. 2009;27(10):1572–1578.
  • Breedis C, Young G. The blood supply of neoplasms in the liver. Am J Pathol. 1954;30(5):969–977.
  • Ensminger, W.D., et al. A clinical-pharmacological evaluation of hepatic arterial infusions of 5-fluoro-2ʹ-deoxyuridine and 5-fluorouracil. Cancer Res. 1978;38(11 Pt 1):3784–3792.
  • Kemeny, N., et al. Phase I study of hepatic arterial infusion of floxuridine and dexamethasone with systemic irinotecan for unresectable hepatic metastases from colorectal cancer. J Clin Oncol. 2001;19(10):2687–2695.
  • Kemeny, N., et al. Phase I trial of systemic oxaliplatin combination chemotherapy with hepatic arterial infusion in patients with unresectable liver metastases from colorectal cancer. J Clin Oncol. 2005;23(22):4888–4896.
  • Kemeny, N.E., et al. Hepatic arterial infusion versus systemic therapy for hepatic metastases from colorectal cancer: a randomized trial of efficacy, quality of life, and molecular markers (CALGB 9481). J Clin Oncol. 2006;24(9):1395–1403.

••The randomized trial which showed OS rate was significantly longer in the HAI group in comparison to the systemic 5-FU/LV group in unresectable CRLM.

  • Kern, W., et al. Phase I and pharmacokinetic study of hepatic arterial infusion with oxaliplatin in combination with folinic acid and 5-fluorouracil in patients with hepatic metastases from colorectal cancer. Ann Oncol. 2001;12(5):599–603.
  • Ducreux, M., et al. Hepatic arterial oxaliplatin infusion plus intravenous chemotherapy in colorectal cancer with inoperable hepatic metastases: a trial of the gastrointestinal group of the Federation Nationale des Centres de Lutte Contre le Cancer. J Clin Oncol. 2005;23(22):4881–4887.
  • Kemeny, N., et al. Intrahepatic or systemic infusion of fluorodeoxyuridine in patients with liver metastases from colorectal carcinoma. A randomized trial. Ann Intern Med. 1987;107(4):459–465.
  • Rougier, P., et al. Hepatic arterial infusion of floxuridine in patients with liver metastases from colorectal carcinoma: long-term results of a prospective randomized trial. J Clin Oncol. 1992;10(7):1112–1118.
  • Wagman, L.D., et al. A prospective, randomized evaluation of the treatment of colorectal cancer metastatic to the liver. J Clin Oncol. 1990;8(11):1885–1893.
  • Kemeny, N., et al. A randomized trial of intrahepatic infusion of fluorodeoxyuridine with dexamethasone versus fluorodeoxyuridine alone in the treatment of metastatic colorectal cancer. Cancer. 1992;69(2):327–334.

•This study showed that the addition of dexamethasone to HAI FUDR decreased incidence and severity of sclerosing cholangitis.

  • Kemeny, N.E., et al. Randomized phase II trial of adjuvant hepatic arterial infusion and systemic chemotherapy with or without bevacizumab in patients with resected hepatic metastases from colorectal cancer. J Clin Oncol. 2011;29(7):884–889.

•This study showed that the addition of bevacizumab to HAI plus systemic therapy after liver resection increased biliary toxicity without PFS or OS benefit.

  • Chang, A.E., et al. A prospective randomized trial of regional versus systemic continuous 5-fluorodeoxyuridine chemotherapy in the treatment of colorectal liver metastases. Ann Surg. 1987;206(6):685–693.
  • Hohn, D.C., et al. A randomized trial of continuous intravenous versus hepatic intraarterial floxuridine in patients with colorectal cancer metastatic to the liver: the Northern California Oncology Group trial. J Clin Oncol. 1989;7(11):1646–1654.
  • Martin, J., et al. Intra-arterial floxuridine vs systemic fluorouracil for hepatic metastases from colorectal cancer: a randomized trial. Arch Surg. 1990;125(8):1022–1027.
  • Lorenz M, Muller HH. Randomized, multicenter trial of fluorouracil plus leucovorin administered either via hepatic arterial or intravenous infusion versus fluorodeoxyuridine administered via hepatic arterial infusion in patients with nonresectable liver metastases from colorectal carcinoma. J Clin Oncol. 2000;18(2):243–254.
  • Kerr, D.J., et al. Intrahepatic arterial versus intravenous fluorouracil and folinic acid for colorectal cancer liver metastases: a multicentre randomised trial. Lancet. 2003;361(9355):368–373.
  • Mocellin S, Pasquali S, Nitti D. Fluoropyrimidine-HAI (hepatic arterial infusion) versus systemic chemotherapy (SCT) for unresectable liver metastases from colorectal cancer. Cochrane Database Syst Rev. 2009; (3):Art. No.:CD007823. DOI:10.1002/14651858.CD007823.pub2.

••The meta-analysis of 10 randomized trials which compared HAI alone to systemic chemotherapy.

  • Peeters, M., et al. Randomized phase III study of panitumumab with fluorouracil, leucovorin, and irinotecan (FOLFIRI) compared with FOLFIRI alone as second-line treatment in patients with metastatic colorectal cancer. J Clin Oncol. 2010;28(31):4706–4713.
  • Bennouna, J., et al. Continuation of bevacizumab after first progression in metastatic colorectal cancer (ML18147): a randomised phase 3 trial. Lancet Oncol. 2013;14(1):29–37.
  • Van Cutsem, E., et al. Addition of aflibercept to fluorouracil, leucovorin, and irinotecan improves survival in a Phase III randomized trial in patients with metastatic colorectal cancer previously treated with an oxaliplatin-based regimen. J Clin Oncol. 2012;30(28):3499–3506.
  • Middleton, G., et al. A randomised phase III trial of the pharmacokinetic biomodulation of irinotecan using oral ciclosporin in advanced colorectal cancer: results of the Panitumumab, Irinotecan & Ciclosporin in COLOrectal cancer therapy trial (PICCOLO). Eur J Cancer. 2013;49(16):3507–3516.
  • Allen-Mersh, T.G., et al. Randomized trial of regional plus systemic fluorinated pyrimidine compared with systemic fluorinated pyrimidine in treatment of colorectal liver metastases. Eur J Surg Oncol. 2000;26(5):468–473.
  • Gallagher, D.J., et al. Hepatic arterial infusion plus systemic irinotecan in patients with unresectable hepatic metastases from colorectal cancer previously treated with systemic oxaliplatin: a retrospective analysis. Ann Oncol. 2007;18(12):1995–1999.
  • Kemeny, N., et al. Phase I trial of adjuvant hepatic arterial infusion (HAI) with floxuridine (FUDR) and dexamethasone plus systemic oxaliplatin, 5-fluorouracil and leucovorin in patients with resected liver metastases from colorectal cancer. Ann Oncol. 2009;20(7):1236–1241.
  • D’Angelica, M.I., et al. Phase II trial of hepatic artery infusional and systemic chemotherapy for patients with unresectable hepatic metastases from colorectal cancer: conversion to resection and long-term outcomes. Ann Surg. 2015;261(2):353–360.
  • Kemeny, N.E., et al. Conversion to resectability using hepatic artery infusion plus systemic chemotherapy for the treatment of unresectable liver metastases from colorectal carcinoma. J Clin Oncol. 2009;27(21):3465–3471.
  • Sanoff, H.K., et al. Five-year data and prognostic factor analysis of oxaliplatin and irinotecan combinations for advanced colorectal cancer: N9741. J Clin Oncol. 2008;26(35):5721–5727.
  • Fong, Y., et al. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg. 1999;230(3):309–318;. discussion 318–21
  • Nordlinger, B., et al. Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet. 2008;371(9617):1007–1016.
  • Nordlinger, B., et al. Perioperative FOLFOX4 chemotherapy and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC 40983): long-term results of a randomised, controlled, phase 3 trial. Lancet Oncol. 2013;14(12):1208–1215.
  • Kemeny, N., et al. Hepatic arterial infusion of chemotherapy after resection of hepatic metastases from colorectal cancer. N Engl J Med. 1999;341(27):2039–2048.
  • Kemeny NE, Gonen M. Hepatic arterial infusion after liver resection. N Engl J Med. 2005;352(7):734–735.
  • Kemeny, N., et al. Phase I/II study of hepatic arterial therapy with floxuridine and dexamethasone in combination with intravenous irinotecan as adjuvant treatment after resection of hepatic metastases from colorectal cancer. J Clin Oncol. 2003;21:3303–3309.
  • Liu W, Song QK, Xing BC. A systematic review and meta-analysis to reappraise the role of adjuvant hepatic arterial infusion for colorectal cancer liver metastases. Int J Colorectal Dis. 2015;30(8):1091–1102.
  • Kemeny, NE, Chou JF, Boucher TM, et al. Improvement in long-term survival in patients with metastatic colorectal cancer (CRC) after liver resection with modern chemotherapy and hepatic arterial infusion (HAI). J Clin Oncol. 2015;33(suppl):abstr 3563.
  • Alberts, S.R., et al. Alternating systemic and hepatic artery infusion therapy for resected liver metastases from colorectal cancer: a North Central Cancer Treatment Group (NCCTG)/ National Surgical Adjuvant Breast and Bowel Project (NSABP) phase II intergroup trial, N9945/CI-66. J Clin Oncol. 2010;28(5):853–858.
  • Mancuso, A., et al. Hepatic arterial continuous infusion (HACI) of oxaliplatin in patients with unresectable liver metastases from colorectal cancer. Anticancer Res. 2003;23(2C):1917–1922.
  • Dzodic, R., et al. Pharmacokinetic advantage of intra-arterial hepatic oxaliplatin administration: comparative results with cisplatin using a rabbit VX2 tumor model. Anticancer Drugs. 2004;15(6):647–650.
  • Guthoff, I., et al. Hepatic artery infusion using oxaliplatin in combination with 5-fluorouracil, folinic acid and mitomycin C: oxaliplatin pharmacokinetics and feasibility. Anticancer Res. 2003;23(6D):5203–5208.
  • Tsimberidou, A.M., et al. A phase 1 study of hepatic arterial infusion of oxaliplatin in combination with systemic 5-fluorouracil, leucovorin, and bevacizumab in patients with advanced solid tumors metastatic to the liver. Cancer. 2010;116(17):4086–4094.
  • Boige, V., et al. Hepatic arterial infusion of oxaliplatin and intravenous LV5FU2 in unresectable liver metastases from colorectal cancer after systemic chemotherapy failure. Ann Surg Oncol. 2008;15(1):219–226.
  • Allard, M.A., et al. Comparison of complete pathologic response and hepatic injuries between hepatic arterial infusion and systemic administration of oxaliplatin in patients with colorectal liver metastases. Ann Surg Oncol. 2015;22(6):1925–1932.

•This study showed that HAI oxaliplatin provided better response rate in liver with the cost of worse liver toxicity than IV oxaliplatin.

  • Goere, D., et al. Prolonged survival of initially unresectable hepatic colorectal cancer patients treated with hepatic arterial infusion of oxaliplatin followed by radical surgery of metastases. Ann Surg. 2010;251(4):686–691.
  • Lewandowski, R.J., et al. 90Y microsphere (TheraSphere) treatment for unresectable colorectal cancer metastases of the liver: response to treatment at targeted doses of 135-150 Gy as measured by [18F]fluorodeoxyglucose positron emission tomography and computed tomographic imaging. J Vasc Interv Radiol. 2005;16(12):1641–1651.
  • Mulcahy, M.F., et al. Radioembolization of colorectal hepatic metastases using yttrium-90 microspheres. Cancer. 2009;115(9):1849–1858.
  • Cosimelli, M., et al. Multi-centre phase II clinical trial of yttrium-90 resin microspheres alone in unresectable, chemotherapy refractory colorectal liver metastases. Br J Cancer. 2010;103(3):324–331.
  • Grothey, A., et al. Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet. 2013;381(9863):303–312.
  • Sofocleous, C.T., et al. Radioembolization as a salvage therapy for heavily pretreated patients with colorectal cancer liver metastases: factors that affect outcomes. Clin Colorectal Cancer. 2015;14(4):296–305.
  • Lahti, S.J., et al. KRAS status as an independent prognostic factor for survival after yttrium-90 radioembolization therapy for unresectable colorectal cancer liver metastases. J Vasc Interv Radiol. 2015;26(8):1102–1111.
  • Kennedy, A.S., et al. Multicenter evaluation of the safety and efficacy of radioembolization in patients with unresectable colorectal liver metastases selected as candidates for (90)Y resin microspheres. J Gastrointest Oncol. 2015;6(2):134–142.
  • Chua, T.C., et al. Radioembolization and systemic chemotherapy improves response and survival for unresectable colorectal liver metastases. J Cancer Res Clin Oncol. 2011;137(5):865–873.
  • Bester, L., et al. Radioembolization versus standard care of hepatic metastases: comparative retrospective cohort study of survival outcomes and adverse events in salvage patients. J Vasc Interv Radiol. 2012;23(1):96–105.
  • Kemeny N. The management of resectable and unresectable liver metastases from colorectal cancer. Curr Opin Oncol. 2010;22(4):364–373.
  • Cianni, R., et al. Selective internal radiation therapy with SIR-spheres for the treatment of unresectable colorectal hepatic metastases. Cardiovasc Intervent Radiol. 2009;32(6):1179–1186.
  • Kennedy, A.S., et al. Resin 90Y-microsphere brachytherapy for unresectable colorectal liver metastases: modern USA experience. Int J Radiat Oncol Biol Phys. 2006;65(2):412–425.
  • Gray, B., et al. Randomised trial of SIR-Spheres plus chemotherapy vs. chemotherapy alone for treating patients with liver metastases from primary large bowel cancer. Ann Oncol. 2001;12(12):1711–1720.

••The study led to the FDA approval of SIR-Spheres as a device in metastatic colorectal cancer.

  • Van Hazel, G., et al. Randomised phase 2 trial of SIR-Spheres plus fluorouracil/leucovorin chemotherapy versus fluorouracil/leucovorin chemotherapy alone in advanced colorectal cancer. J Surg Oncol. 2004;88(2):78–85.
  • Sharma, R.A., et al. Radioembolization of liver metastases from colorectal cancer using yttrium-90 microspheres with concomitant systemic oxaliplatin, fluorouracil, and leucovorin chemotherapy. J Clin Oncol. 2007;25(9):1099–1106.
  • Gibbs, P, Heinemann V, Sharma NK, et al. SIRFLOX: Randomized phase III trial comparing first-line mFOLFOX6 ± bevacizumab (bev) versus mFOLFOX6 + selective internal radiation therapy (SIRT) ± bev in patients (pts) with metastatic colorectal cancer (mCRC). J Clin Oncol. 2015;33(suppl):abstr 3502.
  • Kosmider, S., et al. Radioembolization in combination with systemic chemotherapy as first-line therapy for liver metastases from colorectal cancer. J Vasc Interv Radiol. 2011;22(6):780–786.
  • Hendlisz, A., et al. Phase III trial comparing protracted intravenous fluorouracil infusion alone or with yttrium-90 resin microspheres radioembolization for liver-limited metastatic colorectal cancer refractory to standard chemotherapy. J Clin Oncol. 2010;28(23):3687–3694.
  • van Hazel, G.A., et al. Treatment of fluorouracil-refractory patients with liver metastases from colorectal cancer by using yttrium-90 resin microspheres plus concomitant systemic irinotecan chemotherapy. J Clin Oncol. 2009;27(25):4089–4095.
  • Lim, L., et al. A prospective evaluation of treatment with Selective Internal Radiation Therapy (SIR-spheres) in patients with unresectable liver metastases from colorectal cancer previously treated with 5-FU based chemotherapy. BMC Cancer. 2005;5:132.
  • Kato, T., et al. Arterial chemoembolization with microencapsulated anticancer drug. An approach to selective cancer chemotherapy with sustained effects. JAMA. 1981;20:1123–1127.
  • Patt, Y.Z., et al. The palliative role of hepatic arterial infusion and arterial occlusion in colorectal carcinoma metastatic to the liver. Lancet. 1981;1:349–350.
  • Kobayashi, H., et al. Intra-arterial injection of adriamycin/mitomycin C lipiodol suspension in liver metastases. Acta Radiol. 1987;28:275–280.
  • Inoue, H., et al. Treatment of liver metastases by arterial injection of adriamycin/mitomycin C lipiodol suspension. Acta Radiol. 1989;30:603–608.
  • Taniguchi, H., et al. Intraarterial infusion chemotherapy for metastatic liver tumors using multiple anti-cancer agents suspended in a lipid contrast medium. Cancer. 1989;64:2001–2006.
  • Yamashita, Y., et al. Intraarterial infusion of 5-fluoro-2-deoxyurdine-C8 dissolved in a lymphographic agent in malignant tumors. A preliminary report. Cancer. 1989;64:2437–2444.
  • Kameyama, M., et al. Delayed washout of intratumor blood-flow is associated with good response to intraarterial chemoembolization for liver metastasis of colorectal-cancer. Surgery. 1993;114:97–101.
  • Feun, L.G., et al. A phase I study of chemoembolization with cisplatin and lipiodol for primary and metastatic liver cancer. Am J Clin Oncol. 1994;17:405–410.
  • Lang EK, Brown CL. Colorectal metastases to the liver: selective chemoembolization. Radiology. 1993;189:417–422.
  • Soulen MC. Chemoembolization of hepatic malignancies. Oncology. 1994;8:77–89.
  • Sanz-Altamira, P.M., et al. Selective chemoembolization in the management of hepatic metastases in refractory colorectal carcinoma. Dis Colon Rectum. 1997;40:770–775.
  • Lorenz, M., et al. Temporary chemoembolization of colorectal liver metastases with degradable starch microspheres. Eur J Surg Oncol. 1989;15:453–462.
  • Starkhammar, H., et al. Intra-arterial mitomycin C treatment of unresectable liver tumours. Preliminary results on the effect of degradable starch microspheres. Acta Oncol. 1987;26:295–300.
  • Wollner, I.S., et al. Phase II study of hepatic arterial degradable starch microspheres and mitomycin. Cancer Drug Deliv. 1986;4:279–284.
  • Flowerdew, A.D.S., et al. Prospective randomized controlled trial of hepatic arterial embolization or infusion chemotherapy with 5-fluorouracil and degradable starch microspheres for colorectal liver metastases. Br J Surg. 1990;77:779–782.
  • Aronsen, K.F., et al. Controlled blocking of hepatic artery flow with enzymatically degradable microspheres combined with oncolytic drugs. Eur Surg Res. 1979;11:99–106.
  • Daniels, S., et al. Hepatic artery chemoembolization for carcinoma of colon using angiostat collagen and cisplatin, mitomycin and doxorubicin: response, survival and serum drug levels. Proc Am Soc Clin Oncol. 1992;11:171.
  • Meakem, T.J., et al. CT findings after hepatic chemoembolization. J Comput Assist Tomogr. 1992;16:916–920.
  • Fischbach, R., et al. Transcatheter hepatic artery chemoembolization of primary and secondary liver neoplasms: response rates and survival times. Cardiovasc Intervent Radiol. 1992;15:s35.
  • Martinelli, D.J., et al. Utility of embolization or chemoembolization as second-line treatment in patients with advanced or recurrent colorectal carcinoma. Cancer. 1994;74:1706–1712.
  • Albert, M., et al. Chemoembolization of colorectal liver metastases with cisplatin, doxorubicin, mitomycin C, ethiodol, and polyvinyl alcohol. Cancer. 2011;117(2):343–352.
  • Massmann, A., et al. Transarterial chemoembolization (TACE) for colorectal liver metastases-current status and critical review. Langenbecks Arch Surg. 2015;400:641–659.
  • Liu, D.M., et al. A review of conventional and drug-eluting chemoembolization in the treatment of colorectal liver metastases: principles and proof. Future Oncol. 2015;11:1421–1428.
  • Richardson AJ, Laurence JM, Lam VWT. Transarterial chemoembolization with irinotecan beads in the treatment of colorectal liver metastases: systematic review. J Vasc Interv Radiol. 2013;24(p):1209–1217.

••Article provides comprehensive overview of development of irinotecan beads in colorectal liver metastases.

  • Aliberti, C., et al. Trans-arterial chemoembolization (TACE) of liver metastases from colorectal cancer using irinotecan-eluting beads: preliminary results. Anticancer Res. 2006;26:3793–3795.
  • Fiorentini, G., et al. Intraarterial hepatic chemoembolization of liver metastases from colorectal cancer adopting irinotecan-eluting beads: results of a phase II clinical study. In Vivo. 2007;21:1085–1092.

••First phase III study investigating DEBIRI published in colorectal liver metastases.

  • Martin, R.C.G., et al. Transarterial chemoembolization of metastatic colorectal carcinoma with drug-eluting beads, irinotecan (DEBIRI): multi-institutional registry. J Oncol. 2009;2009:Article ID 539795, 6 pages.
  • Martin, R.C.G., et al. Hepatic intraarterial injection of drug-eluting bead, irinotecan (DEBIRI) in unresectable colorectal liver metastases refractory to systemic chemotherapy: results of multi-institutional study. Ann Surg Oncol. 2011;18:192–198.
  • Aliberti, C., et al. Trans-arterial chemoembolization of metastatic colorectal carcinoma to the liver adopting DC Bead®, drug-eluting bead loaded with irinotecan: results of a phase II clinical study. Anticancer Res. 2011;31:4581–4587.
  • Fiorentini, G., et al. Intra-arterial infusion of irinotecan-loaded drug-eluting beads (DEBIRI) versus intravenous therapy (FOLFIRI) for hepatic metastases from colorectal cancer: final results of a phase III study. Anticancer Res. 2012;32:1387–1395.
  • Eichler, K., et al. First human study in treatment of unresectable liver metastases from colorectal cancer with irinotecan-loaded beads (DEBIRI). Int J Oncol. 2012;41:1213–1220.
  • Martin, R.C.G., et al. Irinotecan drug-eluting beads in the treatment of chemo-naive unresectable colorectal liver metastasis with concomitant systemic fluorouracil and oxaliplatin: results of pharmacokinetics and phase I trial. J Gastrointest Surg. 2012;16:1531–1538.
  • Narayanan, G., et al. Transarterial chemoembolization using DEBIRI for treatment of hepatic metastases from colorectal cancer. Anticancer Res. 2013;33:2077–2083.
  • Kekez, D., et al. Fluorouracil, leucovorin and irinotecan combined with intra-arterial hepatic infusion of drug-eluting beads preloaded with irinotecan in unresectable colorectal liver metastases: side effects and results of a concomitant treatment schedule. Clinical investigation. Tumori. 2014;100:499–503.
  • Stutz, M., et al. Real-life report on chemoembolization using DEBIRI for liver metastases from colorectal cancer. Gastroenterol Res Pract. 2015;2015:Article ID 715102, 6 pages.
  • Huppert P, Wenzel T, Wietholtz H. Transcatheter arterial chemoembolization (TACE) of colorectal cancer liver metastases by irinotecan-eluting microspheres in a salvage patient population. Cardiovasc Intervent Radiol. 2014;37:154–164.
  • Akinwande, O.K., et al. Concomitant capecitabine with hepatic delivery of drug eluting beads in metastatic colorectal cancer. Anticancer Res. 2014;34:7239–7246.
  • Iezzi, R., et al. Trans-arterial chemoembolization with irinotecan-loaded drug-eluting beads (DEBIRI) and capecitabine in refractory liver prevalent colorectal metastases: a phase II single-center study. Cardiovasc Intervent Radiol. 2015. DOI:10.1007/s00270-015-1080-9.
  • Fiorentini, G., et al. Locoregional therapy and systemic cetuximab to treat colorectal liver metastases. World J Gastrointest Oncol. 2015;7:47–54.
  • Martin, R.C.G., et al. Randomized controlled trial of irinotecan drug-eluting beads with simultaneous FOLFOX and bevacizamab for patients with unresectable colorectal liver-limited metastasis. Cancer. 2015. DOI:10.1002/cncr.29534.
  • Akinwande, O.K., et al. Small versus large-sized drug-eluting beads (DEBIRI) for the treatment of hepatic colorectal metastases: a propensity score matching analysis. Cardiovasc Intervent Radiol. 2015;38:361–371.
  • Fiorentini, G., et al. TACE of liver metastases from colorectal cancer adopting irinotecan-eluting beads: beneficial effect of palliative intra-arterial lidocaine and post-procedure supportive therapy on the control of side effects. Hepatogastroenterology. 2008;55:2077–2082.
  • Martin, R.C., et al. Transarterial chemoembolisation (TACE) using irinotecan-loaded beads for the treatment of unresectable metastases to the liver in patients with colorectal cancer: an interim report. World J Surg Oncol. 2009;7:80.
  • Fiorentini, G., et al. Transarterial chemoembolization of metastatic colorectal carcinoma (MCRC) to the liver adoptin polyvinyl alcohol microspheres (PAM) loaded with irinotecan compared with FOLFIRI (CT): evaluation at two years of a phase III clinical trial. Ann Oncol. 2010;21(suppl 89):viii 198–vii 224.
  • Bower, M., et al. Surgical downstaging and neo-adjuvant therapy in metastatic colorectal carcinoma with irinotecan drug-eluting beads: a multi-institutional study. HPB. 2010;12:31–36.
  • Brown, R.E., et al. Hepatectomy after hepatic arterial therapy with either yttrium-90 or drug-eluting bead chemotherapy: is it safe? HPB. 2011;13:91–95.
  • Jones, R.P., et al. Segmental and lobar administration of drug-eluting beads delivering irinotecan leads to tumour destruction: a case-control series. HPB. 2013;15:71–77.
  • Jones, R.P., et al. Hepatic activation of irinotecan predicts tumour response in patients with colorectal liver metastases treated with DEBIRI: exploratory findings from a phase II study. Cancer Chemother Pharmacol. 2013;72:359–368.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Order Reprints Request Corporate Permissions

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

Request Academic Permissions

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.

Related research

People also read lists articles that other readers of this article have read.

Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.

Cited by lists all citing articles based on Crossref citations.
Articles with the Crossref icon will open in a new tab.