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Intrahepatic Oxaliplatin and Systemic 5-FU +/- Cetuximab in Chemo-Naïve Patients with Liver Metastases from Colorectal Cancer

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BACKGROUND: In case of response to chemotherapy, unresectable liver metastases from colorectal cancer can be converted to resectable and thereby obtain a chance of cure. The primary aim of this trial was to evaluate the response rate with intrahepatic oxaliplatin in combination with systemic 5-FU +/- cetuximab. Secondary aims were to evaluate the conversion rate from unresectable to resectable liver metastases, median progression-free survival, median overall survival, and toxicity.

METHODS: Forty-five chemo-naïve patients with liver metastases from colorectal cancer were treated in a prospective phase II trial. Calcium folinate and 5-FU were delivered systemically while oxaliplatin was delivered alternating between systemic and intrahepatic administration. When oxaliplatin was delivered intrahepatic-ally, infusion time was reduced to 10 min followed by embolic material. In patients with KRAS wild-type tumors, cetuximab was added.

RESULTS: The treatment was well tolerated and only pain in the liver and a mild increase in liver enzymes were observed after intrahepatic oxaliplatin. The patients obtained a response rate of 82%. Further, 58% converted from having unresectable to resectable liver metastases. The median overall survival and progression-free survival were 38.7 months (95% confidence interval [CI] 33.0-44.3) and 12.9 months (95% CI 10.2-15.6), respectively.

CONCLUSIONS: Intrahepatic infusion of oxaliplatin in 10 min with systemic 5-FU to patients with chemo-naïve colorectal cancer is feasible and with low toxicity. A high response rate and long median overall survival were obtained.

Original languageEnglish
JournalOncology
Volume96
Issue number6
Pages (from-to)299-308
Number of pages10
ISSN0030-2414
DOIs
Publication statusPublished - 2019

    Research areas

  • Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols/administration & dosage, Cetuximab/administration & dosage, Colorectal Neoplasms/drug therapy, Drug Administration Schedule, Female, Fluorouracil/administration & dosage, Humans, Infusions, Intra-Arterial, Liver Neoplasms/drug therapy, Male, Middle Aged, Oxaliplatin/administration & dosage, Progression-Free Survival, Prospective Studies, Proto-Oncogene Proteins p21(ras)/genetics, Treatment Outcome

ID: 59089829