Irinotecan hepatic arterial infusion chemotherapy for hepatic metastases from colorectal cancer: a phase II clinical study

The advantage of delivering chemotherapy by hepatic arterial infusion is the acquisition of a high concentration of the drug in the target. Irinotecan (CPT-11) is active for the treatment of advanced colorectal cancer. In phase I studies, doses of 20 mg/m2/d for 5 days given every 4 weeks as continu...

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Bibliographic Details
Published in:Tumori 2003-07, Vol.89 (4), p.382-384
Main Authors: Fiorentini, Giammaria, Rossi, Susanna, Dentico, Patrizia, Bernardeschi, Paolo, Calcinai, Alessandra, Bonechi, Francesco, Cantore, Maurizio, Guadagni, Stefano, De Simone, Michele
Format: Article
Language:English
Subjects:
Aged
Antineoplastic Agents, Phytogenic - administration & dosage
Camptothecin - administration & dosage
Camptothecin - analogs & derivatives
Colorectal Neoplasms - pathology
Drug Administration Schedule
Female
Hepatic Artery
Humans
Infusions, Intra-Arterial
Liver Neoplasms - drug therapy
Liver Neoplasms - secondary
Male
Middle Aged
Treatment Outcome
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Summary:The advantage of delivering chemotherapy by hepatic arterial infusion is the acquisition of a high concentration of the drug in the target. Irinotecan (CPT-11) is active for the treatment of advanced colorectal cancer. In phase I studies, doses of 20 mg/m2/d for 5 days given every 4 weeks as continuous infusion or 200 mg/m2 as a short 30-min infusion given every 3 weeks is recommended for phase II studies. Twelve patients with a median liver substitution of 30% (20-50%) were enrolled, 6 progressed after a FOLFOX-induced partial response and 6 progressed after 5-fluorouracil and folinic acid. All patients had a surgically (n = 6) or angiographically placed port (n = 6). They received hepatic arterial infusion chemotherapy with CPT-11 (200 mg/m2) on an out-patient basis, every 3 weeks as a short 30-min infusion for six cycles. Four partial responses were observed (33%) lasting 24, 15, 12 and 8+ weeks, 3 stable disease (25%) lasting more than 12 weeks, and 5 progressions (41%). Six patients (50%) presented a >30% reduction in CEA. Toxicity was G2 diarrhea in 5 patients (41%) and G2 myelosuppression in 6 (50%); one patient had abdominal right upper quadrant pain requiring analgesics. CPT-11 is active as hepatic arterial infusion chemotherapy in liver metastases from colorectal cancer and can rescue systemically pretreated patients. Our schedule seems safe, feasible and well accepted on an out-patient basis.
ISSN:0300-8916
2038-2529
DOI:10.1177/030089160308900406