Although the main objective of the study was to evaluate the toxi

Although the main objective of the study was to evaluate the toxicity of the combined regimen, the treatment produced a high response rate (74%) and was well tolerated. Eight patients became amenable to hepatic cryosurgery. The selleck kinase inhibitor median progression-free and overall survivals were 8.1 and 17.2 months for patients who did not undergo cryosurgery. In the group that underwent cryosurgery, median time to progression was 17.3 months. During a median follow-up of

26.4 months after surgery, only one patient died of disease. In another phase I experience Inhibitors,research,lifescience,medical using HAI FUDR and dexamethasone along with systemic oxaliplatin combinations (A: oxaliplatin and irinotecan or B: oxaliplatin and 5-FU/LV) in 36 patients with unresectable liver metastases, response and survival were again high (36). In this series, 89% of the patients had received prior chemotherapy, and 69.4% had prior irinotecan. The partial response rates were 90% and 87% for arms A and B, respectively. Seven patients Inhibitors,research,lifescience,medical in group A were able to undergo hepatic resection. The median survival time was 35.8 and 22 months for groups A and B, respectively. In a more recent study, the results in Arm A were confirmed. In 49 patients, response rate was 92% with a median survival

of 41 months from the Inhibitors,research,lifescience,medical time of HAI therapy initiation, even though 53% were previously treated (36). In a retrospective analysis, Gallagher et al. (41) reported a high partial response rate (44%) with systemic irinotecan plus HAI FUDR/dexamethasone in patients with metastatic CRC to the liver who progressed on oxaliplatin-based chemotherapy. The median survival was 20 months from the start of HAI therapy and 18% of patients were able to undergo surgical resection or ablation. Administration of newer chemotherapy agents via HAI associated with systemic 5-FU-based therapy may be another Inhibitors,research,lifescience,medical approach in this setting. In a phase I study, 21 patients with hepatic metastases from CRC were treated with HAI oxaliplatin plus intravenous 5-FU/LV (42). The treatment regimen, which was administered every 3 weeks, consisted of 5-FU 600 mg/m2 and LV 200 mg/m2 intravenous combined with 25 mg/m2 oxaliplatin HAI with

dose Inhibitors,research,lifescience,medical increments of 25 mg/m2. The limiting toxicities observed at an oxaliplatin dose of 150 mg/m2/cycle were leukopenia, occlusion of the hepatic artery, and acute pancreatitis. The recommended dose was 125 mg/m2 every 3 weeks. Overall, Farnesyltransferase 24% of the patients achieved a complete response, with an overall response rate of 59%. The median time to progression had not been reached at the cutoff date, with a median follow-up of 6.7 months. In another phase I-II study conducted by Fiorentini et al. (43), 12 previously-treated (irinotecan, oxaliplatin and/or 5-FU/LV) patients with progressive CRC liver metastases received HAI with oxaliplatin as a 30 minute infusion every 3 weeks. Dose-limiting toxicity was observed at 175 mg/m2/cycle and consisted of occlusion of the hepatic artery, abdominal pain and severe hypotension.

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