Hepatic arterial infusion therapy in advanced cancer and liver-predominant disease: The MD Anderson experience

Background/Aims: Liver metastases in patients with cancer are associated with a poor prognosis. We assessed the clinical outcomes in patients with advanced cancer and predominant liver involvement treated on hepatic arterial infusion (HAI) chemotherapy protocols. Methodology: We retrospectively analyzed the outcomes of patients referred to the Phase I Clinical Trials Program between April 2004 and September 2009. Results: Overall, 202 consecutive patients were identified. Of 189 evaluable patients, the rates of partial response (PR) and stable disease (SD) ≥4 months were 6.3% and 23%, respectively. In patients with hepatocellular carcinoma or cholangiocarcinoma (n = 15), 5 (33%) had SD ≥4 months. In patients with colorectal cancer (n = 67) treated with HAI oxaliplatin or irinotecan combination therapy, the rates of PR and SD ≥4 months were 7.5% and 34.3%, respectively. In patients with breast cancer (n = 17) treated with HAI cisplatin-based therapy, the rates of PR and SD ≥4 months were 17.6% and 35.3%, respectively. The median survival of patients with PR and SD ≥4 months was 11.6 months. Independent factors predicting shorter survival were male gender; decreased albumin and hemogloblin; and elevated bilirubin, lactate dehydrogenase and alanine aminotransferase. Conclusions: HAI combination therapies have antitumor activity in selected heavily pretreated patients with certain tumor types and liver involvement.