Hepatic arterial infusion therapy in advanced cancer and liver-predominant disease: the MD Anderson Experience.
Hepatic arterial infusion therapy in advanced cancer and liver-predominant disease: the MD Anderson Experience.
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DOI：
10.5754/hge12257
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发表时间：
2013-10
影响因子：
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通讯作者：
A. Tsimberidou;C. Vaklavas;S. Fu;S. Wen;Joann Lim;D. Hong;J. Wheler;A. Naing;C. Uehara;M. Wallace;R. Kurzrock
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文献类型：
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作者：
A. Tsimberidou;C. Vaklavas;S. Fu;S. Wen;Joann Lim;D. Hong;J. Wheler;A. Naing;C. Uehara;M. Wallace;R. Kurzrock
背景/目的癌症患者的肝转移与不良预后相关。我们评估了肝动脉灌注（HAI化疗方案）治疗晚期癌症和主要肝脏受累患者的临床结局。方法：我们回顾性分析了2004年4月至2009年9月期间纳入I期临床试验项目的患者的结局。结果：共识别出202例连续患者。在189例可评价患者中，部分缓解（PR）和疾病稳定（SD）>4个月的比例分别为6.3%和23%。在肝细胞癌或胆管细胞癌患者（n = 15）中，5例（33%）SD ≥ 4个月。在接受HA 1奥沙利铂或伊立替康联合治疗的结直肠癌患者（n = 67）中，PR和SD ≥ 4个月的发生率分别为7.5%和34.3%。在接受以HAI顺铂为基础的治疗的乳腺癌患者（n = 17）中，PR和SD-4个月的发生率分别为17.6%和35.3%。PR和SD ≥ 4个月患者的中位生存期为11.6个月。预测生存期较短的独立因素是男性;白蛋白和血红蛋白降低;胆红素、乳酸脱氢酶和丙氨酸氨基转移酶升高。结论：HAI联合治疗对某些肿瘤类型和肝脏受累的重度预治疗患者具有抗肿瘤活性。
BACKGROUND/AIMS Liver metastases in patients with cancer are associated with a poor prognosis. We assessed the clinical outcomes in patients with advanced cancer and predominant liver involvement treated on hepatic arterial infusion (HAI chemotherapy protocols. METHODOLOGY We retrospectively analyzed the outcomes of patients referred to the Phase I Clinical Trials Program between April 2004 and September 2009. RESULTS Overall, 202 consecutive patients were identified. Of 189 evaluable patients, the rates of partial response (PR) and stable disease (SD) >4 months were 6.3% and 23%, respectively. In patients with hepatocellular carcinoma or cholangiocarcinoma (n = 15), 5 (33%) had SD ≥ 4 months. In patients with colorectal cancer (n = 67) treated with HAl oxaliplatin or irinotecan combination therapy, the rates of PR and SD ≥ 4 months were 7.5% and 34.3%, respectively. In patients with breast cancer (n = 17) treated with HAI cisplatin-based therapy, the rates of PR and SD -4 months were 17.6% and 35.3%, respectively. The median survival of patients with PR and SD ≥ 4 months was 11.6 months. Independent factors predicting shorter survival were male gender; decreased albumin and hemogloblin; and elevated bilirubin, lactate dehydrogenase and alanine aminotransferase. CONCLUSIONS HAI combination therapies have antitumor activity in selected heavily pretreated patients with certain tumor types and liver involvement.