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Hepatic arterial therapy with oxaliplatin and systemic capecitabine for patients with liver metastases from breast cancer

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OBJECTIVES: Hepatic arterial treatment (HAT) for liver metastases in patients with metastatic breast cancer (MBC) has only been investigated in few studies.

MATERIALS AND METHODS: Two phase II trials were initiated simultaneously to evaluate capecitabine in combination with oxaliplatin in patients with MBC and liver metastases. These two trials are reported together. Continuous capecitabine (1300 mg/m2) was combined with oxaliplatin (85 mg/m2) alternating between systemic treatment and HAT followed by degradable starch microspheres with EmboCept® S every second week. Four patients participated in a pharmacokinetic analysis of oxaliplatin. Each patient had samples taken when receiving oxaliplatin systemically and as HAT with and without EmboCept® S.

RESULTS: Totally, 52 patients received HAT: 14 with liver metastases only and 38 patients with additional limited metastatic disease. The patients had previously received a median of 2 (range 0-6) chemotherapeutic regimens for MBC. The response rate was 42.3% (95% confidence interval (CI) 28.7-56.8%) with 7.7% complete and 34.6% partial responses. Median progression free survival was 10.8 months (95% CI 6.9-14.7 months) and median overall survival 27.6 months (95% CI 20.4-34.8 months). The toxicity was moderate with hand-foot syndrome (15.4%), neuropathy (9.6%), fatigue (9.6%), and abdominal pain (9.6%) being the most common grade 3 adverse events. There was no clear difference between systemic blood concentrations of oxaliplatin when given systemic or as HAT.

CONCLUSION: HAT oxaliplatin in combination with capecitabine is safe and efficient in patients with MBC. The results are promising with high response rates and a long median progression free and overall survival.

Original languageEnglish
JournalBreast
Volume43
Pages (from-to)113-119
Number of pages7
ISSN0960-9776
DOIs
Publication statusPublished - Feb 2019

    Research areas

  • Abdominal Pain/chemically induced, Adenocarcinoma/secondary, Adult, Aged, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Breast Neoplasms/pathology, Capecitabine/administration & dosage, Chemoembolization, Therapeutic/methods, Fatigue/chemically induced, Female, Hand-Foot Syndrome/etiology, Hepatic Artery, Humans, Liver Neoplasms/secondary, Middle Aged, Oxaliplatin/administration & dosage, Peripheral Nervous System Diseases/chemically induced, Progression-Free Survival

ID: 59410698