Perioperative and Oncologic Outcomes of Hepatic Arterial Infusion (HAI) Pump Chemotherapy for Patients with Unresectable Colorectal Liver Metastases at an Expanding HAI Program.

Autor: Liu A; Department of Surgery, Duke University Medical Center, Durham, NC, USA., Lowe M; Duke Cancer Institute-Biostatistics Shared Resource, Durham, NC, USA., Niedzwiecki D; Duke Cancer Institute-Biostatistics Shared Resource, Durham, NC, USA., Rhodin KE; Department of Surgery, Duke University Medical Center, Durham, NC, USA., Sharib J; Department of Surgery, University of Washington Medical Center, Seattle, WA, USA., Wildman-Tobriner B; Department of Radiology, Duke University Medical Center, Durham, NC, USA., Wong TZ; Department of Radiology, Duke University Medical Center, Durham, NC, USA., Kim CY; Department of Radiology, Duke University Medical Center, Durham, NC, USA., Thacker J; Department of Surgery, Duke University Medical Center, Durham, NC, USA., Mantyh C; Department of Surgery, Duke University Medical Center, Durham, NC, USA., Migaly J; Department of Surgery, Duke University Medical Center, Durham, NC, USA., Lan BY; Department of Surgery, Duke University Medical Center, Durham, NC, USA., Strickler JH; Department of Medicine, Duke University Medical Center, Durham, NC, USA., David Hsu S; Department of Medicine, Duke University Medical Center, Durham, NC, USA., Nussbaum D; Department of Surgery, Duke University Medical Center, Durham, NC, USA., Zani S; Department of Surgery, Duke University Medical Center, Durham, NC, USA., Uronis H; Department of Medicine, Duke University Medical Center, Durham, NC, USA., Allen PJ; Department of Surgery, Duke University Medical Center, Durham, NC, USA., Lidsky ME; Department of Surgery, Duke University Medical Center, Durham, NC, USA. Michael.lidsky@duke.edu.
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2024 Nov 20. Date of Electronic Publication: 2024 Nov 20.
DOI: 10.1245/s10434-024-16488-y
Abstrakt: Background: Hepatic arterial infusion (HAI) is an established treatment for patients with unresectable colorectal liver metastases (uCRLM). Until recently, HAI was only performed at a limited number of centers. We previously reported early outcomes suggesting that implementation of a new HAI program is safe and feasible. Here, we report perioperative and oncologic outcomes from an expanded series of patients with uCRLM treated with HAI.
Methods: We analyzed outcomes from consecutive patients with uCRLM who underwent HAI pump (HAIP) placement at Duke University Hospital from 2018 to 2023. Demographics, prior treatment, and perioperative and oncologic outcomes were assessed.
Results: Overall, 102 patients underwent HAIP placement for uCRLM; 62% were male and median age was 51 years. Most patients (97%) received a median of 12 (range 0-66) prior chemotherapy cycles. Postoperative HAI-specific complications occurred in 23% of patients, including biliary sclerosis in 6%, and the 90-day mortality rate was 3%. 20% converted to resection, 4% underwent transplant, and 2% achieved complete response at 6 months after floxuridine initiation. Median hepatic and extrahepatic progression-free survival (PFS) was 15.7 months and 11.6 months, respectively. Median overall survival (OS) was 38 months from the time of pump implantation (median follow-up time: 30 months).
Conclusions: HAI for uCRLM is safe, feasible, and effective at a new center, with outcomes that recapitulate those previously reported by established centers. Future analysis of our institutional data, which includes mutation status, primary tumor sidedness, and extent of prior therapy could inform selection and treatment strategies for new HAI programs.
Competing Interests: Disclosures: John H. Strickler reports consultant or advisory roles for Abbvie, Agenus, Astellas, AstraZeneca, Bayer, Beigene, Daiichi-Sankyo, Eli Lilly, GSK, Johnson and Johnson, Jazz Pharmaceuticals, Merck, Natera, Pfizer, Roche/Genentech, Regeneron, Sanofi, Taiho, Takeda, and Xilio Therapeutics; stock options for Triumvira Immunologics; and research funding or contracted research for Abbvie, Amgen, AStar D3, Bayer, Beigene, Curegenix, Daiichi-Sankyo, Eli Lilly, Erasca, GSK, Leap Therapeutics, Novartis, Pfizer, Quanta Therapeutics, Revolution Medicines, and Roche/Genentech. Benjamin Wildman-Tobriner reports a consultant role for See-Mode Technologies. Annie Liu, Melissa Lowe, Donna Niedzwiecki, Kristen E. Rhodin, Jeremy Sharib, Terence Z. Wong, Charles Y. Kim, Julie Thacker, Christopher Mantyh, John Migaly, Billy Y. Lan, S. David Hsu, Daniel Nussbaum, Sabino Zani, Hope Uronis, Peter J. Allen, and Michael E. Lidsky have no disclosures to declare that may be relevant to the contents of this study.
(© 2024. Society of Surgical Oncology.)
Databáze: MEDLINE
Externí odkaz: