TY - JOUR
T1 - Irinotecan-Eluting 75–150-μm Embolics Lobar Chemoembolization in Patients with Colorectal Cancer Liver Metastases
T2 - A Prospective Single-Center Phase I Study
AU - Fereydooni, Arash
AU - Letzen, Brian
AU - Ghani, Mansur A.
AU - Miszczuk, Milena A.
AU - Huber, Steffen
AU - Chapiro, Julius
AU - Schlachter, Todd
AU - Geschwind, Jean Francois
AU - Georgiades, Christos
N1 - Publisher Copyright:
© 2018 SIR
PY - 2018/12
Y1 - 2018/12
N2 - Purpose: The primary end point of this trial was to determine the feasibility and safety of transarterial chemoembolization with the use of 75–150-μm drug-eluting embolics loaded with irinotecan (DEE-IRI) for the treatment of metastatic colorectal cancer (CRC) refractory to systemic chemotherapy. Materials and Methods: Fourteen patients (mean age 57.9 years) with liver-dominant metastatic disease (14.3% unilobar, 85.7% bilobar), who had failed at least 1 line of chemotherapy, were enrolled and received up to 4 (mean 2.3) cycles of DEE-IRI lobar transarterial chemoembolization. Technical complications and adverse events were recorded, and response was assessed by means of imaging-based criteria. Levels of irinotecan and angiogenesis biomarkers in the serum were measured at multiple time points. Results: Thirty-two DEE-IRI transarterial chemoembolizations were successfully performed, and the full dose (100 mg) was delivered in all cases. The only grade 3–4 toxicity was abdominal pain (29%). One patient had objective response according to the Response Evaluation Criteria in Solid Tumors and World Health Organization, and 3 patients had objective response according to the European Association for the Study of the Liver. The median overall survival was 18.14 months, and the 1-year survival was 65%. The average plasma C max of the active metabolite was 41.5 ± 26.1 ng/mL, with average T max of 1.3 ± 0.5 hours. The treatment significantly reduced levels of vascular endothelial growth factor receptor 1 (VEGFR1) at 24 hours. Conclusions: Lobar transarterial chemoembolization with the use of DEE-IRI is a technically feasible and well tolerated palliative treatment for patients with refractory liver-predominant CRC metastatic disease and has acceptable pharmacokinetics. VEGFR1 is a potential biomarker for predicting treatment efficacy and risk of adverse events.
AB - Purpose: The primary end point of this trial was to determine the feasibility and safety of transarterial chemoembolization with the use of 75–150-μm drug-eluting embolics loaded with irinotecan (DEE-IRI) for the treatment of metastatic colorectal cancer (CRC) refractory to systemic chemotherapy. Materials and Methods: Fourteen patients (mean age 57.9 years) with liver-dominant metastatic disease (14.3% unilobar, 85.7% bilobar), who had failed at least 1 line of chemotherapy, were enrolled and received up to 4 (mean 2.3) cycles of DEE-IRI lobar transarterial chemoembolization. Technical complications and adverse events were recorded, and response was assessed by means of imaging-based criteria. Levels of irinotecan and angiogenesis biomarkers in the serum were measured at multiple time points. Results: Thirty-two DEE-IRI transarterial chemoembolizations were successfully performed, and the full dose (100 mg) was delivered in all cases. The only grade 3–4 toxicity was abdominal pain (29%). One patient had objective response according to the Response Evaluation Criteria in Solid Tumors and World Health Organization, and 3 patients had objective response according to the European Association for the Study of the Liver. The median overall survival was 18.14 months, and the 1-year survival was 65%. The average plasma C max of the active metabolite was 41.5 ± 26.1 ng/mL, with average T max of 1.3 ± 0.5 hours. The treatment significantly reduced levels of vascular endothelial growth factor receptor 1 (VEGFR1) at 24 hours. Conclusions: Lobar transarterial chemoembolization with the use of DEE-IRI is a technically feasible and well tolerated palliative treatment for patients with refractory liver-predominant CRC metastatic disease and has acceptable pharmacokinetics. VEGFR1 is a potential biomarker for predicting treatment efficacy and risk of adverse events.
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U2 - 10.1016/j.jvir.2018.08.010
DO - 10.1016/j.jvir.2018.08.010
M3 - Article
C2 - 30337148
AN - SCOPUS:85054721271
SN - 1051-0443
VL - 29
SP - 1646-1653.e5
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 12
ER -