Targeting locoregional immunochemotherapy with new drugs in metastatic liver disease: A promising alternative

BACKGROUND/AIMS: A retrospective report of our experience with adjuvant targeted locoregional immunochemotherapy using new drugs in 29 Stage IV colorectal cancer patients with unresectable metastatic Liver disease from September 1997 to December 1998. METHODOLOGY: After pre-operative screening, all patients were subjected to laparotomy for insertion of transhepatic and transplenic arterial catheters, both implanted subcutaneously in the right upper abdominal quadrant. A bolus transhepatic arterial chemotherapy using Eloxatine 150mg/m(2) and Campton 140mg/m(2), suspended in a 5:1 lipiodol-urografin emulsion, was given 15 days postoperatively, followed the day after by 5 daily transplenic artery and then 5 daily transhepatic arterial injections of IL-2 in a 5:1 lipiodol-urografin mixture. This treatment schema was repeated at 2-month intervals. RESULTS: Treatment response was recorded: CR=24.2%, PR=55.2%, SD=10.3%, and PD=10.3%. Seventy-nine percent responded favorably with 7 patients (24.2%) showing marked tumor bulk reductions. There were no treatment-related morbidities or mortalities. CONCLUSIONS: All 29 patients are alive with a median survival of 11 months as of this writing. Eighty percent report a significant improvement in quality of life. Targeted locoregional immunochemotherapy using the above drugs is a promising option for patients with far-advanced metastatic Liver disease.