Response rates of hepatocellular carcinoma and hepatic colorectal cancer metastases to drug eluting bead regional liver therapy

Abstract

Aim: The purpose of this study was to evaluate and compare how hepatocellular carcinoma (HCC) and colorectal metastases respond to LC Bead chemoembolization using doxorubicin and irinotecan.

Methods: The authors report their experience with doxorubicin and irinotecan eluting beads to treat 13 patients with primary HCC and 25 patients with colorectal metastases over a 1-year period at a single community based oncology practice. Within the colorectal cancer group they compared irinotecan eluting beads to doxorubicin eluting beads.

Results: Nine of the 11 (81.8%) doxorubicin treated HCC patients had either complete response or partial response. All of the HCC lesions showed reduction in size and tumor enhancement and 10/11 (91%) HCC patients were alive at 24 months post treatment. Fisher’s exact test revealed that among the 22 with colorectal metastases for whom follow-up data were available, those 11 who were treated with doxorubicin were significantly more likely to demonstrate complete or partial response compared to the 11 in the irinotecan treated group (P < 0.001).

Conclusion: Overall, HCC and colon metastasis patients clearly demonstrated the effectiveness of drug eluting beads with 91% of the HCC patients alive 24 months after treatment.

Keywords

Angiography / transarterial chemoembolization / drug eluting beads / hepatocellular carcinoma / doxorubicin / irinotecan

References

[1] Serrablo A,Ramia JM.Reeves H.Liver Metastases - Surgical Treatment..Liver Tumors - Epidemiology, Diagnosis, Prevention and Treatment.2013;Rijeka, CroatiaInTech

[2] Sasson AR.Surgical treatment of liver metastases..Semin Ocol2002;29:107-18

[3] Singletary SE,Vauthey JN,Sawaya R,Meric F.A role for curative surgery in the treatment of selected patients with metastatic breast cancer..Oncologist2003;8:241-51

[4] Brown DB,Soulen MC,Sacks D.Society of Interventional Radiology position statement on chemoembolization of hepatic malignancies..J Vasc Interv Radiol2006;17:217-23

[5] Lencioni R,De Simone P.Loco-regional interventional treatment of hepatocellular carcinoma: techniques, outcomes, and future prospects..Transpl Int2010;23:698-703

[6] Stambo GW.Hepatic angiosarcoma presenting as an acute intraabdominal hemorrhage treated with transarterial chemoembolization..Sarcoma2007;2007:90169

[7] Aliberti C,Tilli M.Chemomembolization (TACE) of unresectable intrahepatic cholangiocarcinoma with slow-release doxorubicin-eluting beads: preliminary results..Cardiovasc Intervent Radiol2008;31:883-8

[8] Steward MJ,Malhotra A,Buscombe JR.Neuroendocrine tumors: role of interventional radiology in therapy..Radiographics2008;28:1131-45

[9] Varela M,Burrel M,Sala M,Ayuso C,Monta-á X,Bruix J.Chemoembolization of hepatocellular carcinoma with drug eluting beads: efficacy and doxorubicin pharmacokinetics..J Hepatol2007;46:474-81

[10] Liapi E,Georgiades CC,Geschwind JF.Drug-eluting particles for interventional radiology..Tech Vasc Interv Radiol2007;10:261-9

[11] Aliberti C,Benea G.Trans-arterial chemoembolization (TACE) of liver metastases from colorectal cancer using irinotecan-eluting beads: preliminary results..Anticancer Res2006;26:3793-5

[12] Jakub W.Using epirubicin-loaded DC Beads® for superselective embolisation of liver tumours - initial experiences..Eur Oncol2008;4:72-6

[13] Malagari K,Alexopoulou E,Hall B,Delis S,Kelekis D.Transarterial chemoembolization of unresectable hepatocellular carcinoma with drug eluting beads: results of an open-label study of 62 patients..Cardiovasc Intervent Radiol2008;31:269-80

[14] Lewis AL,Lloyd AW,Tang Y,Leppard SW,Palmer RR.DC bead: in vitro characterization of a drug-delivery device for transarterial chemoembolization..J Vasc Interv Radiol2006;17:335-42

[15] Aliberti C,Benea G.Trans-arterial chemoembolizaiton (TACE) of liver metastases from colorectal cancer using irinotecan-eluting beads: preliminary results..Anticancer Res2006;26:3793-5

[16] Taylor RR,Gonzalez MV,Lewis AL.Irinotecan drug eluting beads for use in chemoembolization: in vitro and in vivo evaluation of drug release properties..Eur J Pharm Sci2007;30:7-14

[17] Fiorentini G,Turrisi G,Rossi S,Giovanis P.Intraarterial hepatic chemoembolization of liver metastasis from colorectal cancer adopting irinotecan-eluting beads: results of a phase II clinical study..In Vivo2007;21:1085-91

[18] Lencioni R,Petruzzi P,Bozzi E,Bargellini I,Oliveri F,Bartolozzi C,Filipponi F.Doxorubicin-eluting bead-enhanced radiofrequency ablation of hepatocellular carcinoma: a pilot clinical study..J Hepatol2008;49:217-22

[19] Spada F,Bonomo G,Vigna PD,Boselli S.Hepatic intra-arterial chemotherapy in patients with advanced primary liver tumours..Ecancermedicalscience2012;6:280

[20] Lammer J,Vogl T,Denys A,Pitton M,Pfammatter T,Benhamou Y,Gruenberger T,Langenberger H,Dumortier J,Chevallier P.Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma: results of the PRECISION V study..Cardiovasc Intervent Radiol2010;33:41-52

[21] Biondi M,Lewis AL.Investigation of the mechanisms governing doxorubicin and irinotecan release from drug-eluting beads: mathematical modeling and experimental verification..J Mater Sci Mater Med2013;10:2359-70