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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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@article{0dced570e8c145b0aa0531fd17dda1f4,
title = "Intrahepatic Oxaliplatin and Systemic 5-FU +/- Cetuximab in Chemo-Na{\"i}ve Patients with Liver Metastases from Colorectal Cancer",
abstract = "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-na{\"i}ve 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-na{\"i}ve colorectal cancer is feasible and with low toxicity. A high response rate and long median overall survival were obtained.",
keywords = "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",
author = "Larsen, {Finn Ole} and Jensen, {Benny V} and N{\o}rgaard, {Hans Henrik} and Hermann, {Helle Kirstine} and Larsen, {Peter N} and Alice Markussen and Estrid Hogdall and Dorte Nielsen",
note = "{\circledC} 2019 S. Karger AG, Basel.",
year = "2019",
doi = "10.1159/000499314",
language = "English",
volume = "96",
pages = "299--308",
journal = "Oncology",
issn = "0030-2414",
publisher = "S./Karger AG",
number = "6",

}

RIS

TY - JOUR

T1 - Intrahepatic Oxaliplatin and Systemic 5-FU +/- Cetuximab in Chemo-Naïve Patients with Liver Metastases from Colorectal Cancer

AU - Larsen, Finn Ole

AU - Jensen, Benny V

AU - Nørgaard, Hans Henrik

AU - Hermann, Helle Kirstine

AU - Larsen, Peter N

AU - Markussen, Alice

AU - Hogdall, Estrid

AU - Nielsen, Dorte

N1 - © 2019 S. Karger AG, Basel.

PY - 2019

Y1 - 2019

N2 - 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.

AB - 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.

KW - Aged

KW - Aged, 80 and over

KW - Antineoplastic Combined Chemotherapy Protocols/administration & dosage

KW - Cetuximab/administration & dosage

KW - Colorectal Neoplasms/drug therapy

KW - Drug Administration Schedule

KW - Female

KW - Fluorouracil/administration & dosage

KW - Humans

KW - Infusions, Intra-Arterial

KW - Liver Neoplasms/drug therapy

KW - Male

KW - Middle Aged

KW - Oxaliplatin/administration & dosage

KW - Progression-Free Survival

KW - Prospective Studies

KW - Proto-Oncogene Proteins p21(ras)/genetics

KW - Treatment Outcome

U2 - 10.1159/000499314

DO - 10.1159/000499314

M3 - Journal article

VL - 96

SP - 299

EP - 308

JO - Oncology

JF - Oncology

SN - 0030-2414

IS - 6

ER -

ID: 59089829