Hepatic Arterial Therapy with Drug-eluting Beads in the Management of Metastatic Bronchogenic Carcinoma to the Liver: a Multi-institutional Registry

Overview

Journal J Oncol

Specialty Oncology

Date 2012 Apr 7

PMID 22481920

Citations 2

Authors

Heba Fouad

Tiffany Metzger

Cliff Tatum

Ken Robbins

Robert C G Martin

Affiliations

Soon will be listed here.

Abstract

Introduction. There has been limited information reported on the use of hepatic arterial therapy in liver dominant hepatic metastases arising from lung cancer. The aim of this study was to evaluate the safety and efficacy of hepatic arterial therapy in the treatment of liver dominant hepatic metastases arising from lung cancer. Methods. Thirteen patients underwent a total of 30 treatment sessions with Drug-Eluting Beads. Eight of the thirteen received only doxorubicin DEB (17 of the total treatments), and four patients received Irinotecan DEB (7 of the total treatments). Results. The planned preprocedural dosage was a median of 75 mg (range 19-200), with total hepatic dose exposure being a median of 150 mg (range 0-458), with a technical success rate of 97% in all 29 treatments. There were 4 adverse events related to treatment, but no evidence of hepatic insufficiency. Overall 6-month and 12-month response rates were 50%. After a median followup of 24 months, the median overall survival in this cohort was 14 months (range 7-48 months). Conclusion. Drug-eluting beads loaded with doxorubicin (DEBDOX) or irinotecan (DEBIRI) can be safely and effectively used in treatment of patients with liver predominant metastatic disease from lung cancer.

Citing Articles

Metastatic disease to the liver: Locoregional therapy strategies and outcomes.

Zane K, Cloyd J, Mumtaz K, Wadhwa V, Makary M World J Clin Oncol. 2021; 12(9):725-745.

PMID: 34631439 PMC: 8479345. DOI: 10.5306/wjco.v12.i9.725.

Yttrium-90 microsphere radioembolization for treatment of lung cancer hepatic metastases.

Gaba R, Lakhoo J Case Rep Oncol. 2012; 5(2):479-86.

PMID: 23109925 PMC: 3457031. DOI: 10.1159/000342706.

References

Martin R, Howard J, Tomalty D, Robbins K, Padr R, Bosnjakovic P . Toxicity of irinotecan-eluting beads in the treatment of hepatic malignancies: results of a multi-institutional registry. Cardiovasc Intervent Radiol. 2010; 33(5):960-6. DOI: 10.1007/s00270-010-9937-4. View

Liapi E, Geschwind J . Transcatheter and ablative therapeutic approaches for solid malignancies. J Clin Oncol. 2007; 25(8):978-86. DOI: 10.1200/JCO.2006.09.8657. View

Brambilla E, Gazdar A . Pathogenesis of lung cancer signalling pathways: roadmap for therapies. Eur Respir J. 2009; 33(6):1485-97. PMC: 2762943. DOI: 10.1183/09031936.00014009. View

Kalva S, Thabet A, Wicky S . Recent advances in transarterial therapy of primary and secondary liver malignancies. Radiographics. 2008; 28(1):101-17. DOI: 10.1148/rg.281075115. View

Brown D, Gould J, Gervais D, Goldberg S, Murthy R, Millward S . Transcatheter therapy for hepatic malignancy: standardization of terminology and reporting criteria. J Vasc Interv Radiol. 2007; 18(12):1469-78. DOI: 10.1016/j.jvir.2007.08.027. View

Eble M, Gademann G, Wannenmacher M . [The value of radiotherapy for liver metastases]. Strahlenther Onkol. 1993; 169(8):459-68. View

Artinyan A, Nelson R, Soriano P, Chung V, Retseck J, Reynolds J . Treatment response to transcatheter arterial embolization and chemoembolization in primary and metastatic tumors of the liver. HPB (Oxford). 2008; 10(6):396-404. PMC: 2597318. DOI: 10.1080/13651820802356564. View

Lencioni R, Llovet J . Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis. 2010; 30(1):52-60. DOI: 10.1055/s-0030-1247132. View

Lewis A, Taylor R, Hall B, Victoria Gonzalez M, Willis S, Stratford P . Pharmacokinetic and safety study of doxorubicin-eluting beads in a porcine model of hepatic arterial embolization. J Vasc Interv Radiol. 2006; 17(8):1335-43. DOI: 10.1097/01.RVI.0000228416.21560.7F. View

10.

Molina J, Yang P, Cassivi S, Schild S, Adjei A . Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. Mayo Clin Proc. 2008; 83(5):584-94. PMC: 2718421. DOI: 10.4065/83.5.584. View

11.

Poon R, Tso W, Pang R, Ng K, Woo R, Tai K . A phase I/II trial of chemoembolization for hepatocellular carcinoma using a novel intra-arterial drug-eluting bead. Clin Gastroenterol Hepatol. 2007; 5(9):1100-8. DOI: 10.1016/j.cgh.2007.04.021. View

12.

Martin R, Joshi J, Robbins K, Tomalty D, OHara R, Tatum C . Transarterial Chemoembolization of Metastatic Colorectal Carcinoma with Drug-Eluting Beads, Irinotecan (DEBIRI): Multi-Institutional Registry. J Oncol. 2009; 2009:539795. PMC: 2771155. DOI: 10.1155/2009/539795. View

13.

Levine M, Julian J . Registries that show efficacy: good, but not good enough. J Clin Oncol. 2008; 26(33):5316-9. DOI: 10.1200/JCO.2008.18.3996. View

14.

Hammerschmidt S, Wirtz H . Lung cancer: current diagnosis and treatment. Dtsch Arztebl Int. 2009; 106(49):809-18. PMC: 2797332. DOI: 10.3238/arztebl.2009.0809. View

15.

Schneider B . Non-small cell lung cancer staging: proposed revisions to the TNM system. Cancer Imaging. 2008; 8:181-5. PMC: 2556505. DOI: 10.1102/1470-7330.2008.0029. View

16.

Socinski M, Morris D, Masters G, Lilenbaum R . Chemotherapeutic management of stage IV non-small cell lung cancer. Chest. 2003; 123(1 Suppl):226S-243S. DOI: 10.1378/chest.123.1_suppl.226s. View

17.

Tang Y, Taylor R, Gonzalez M, Lewis A, Stratford P . Evaluation of irinotecan drug-eluting beads: a new drug-device combination product for the chemoembolization of hepatic metastases. J Control Release. 2007; 116(2):e55-6. DOI: 10.1016/j.jconrel.2006.09.047. View

18.

Silvestri G, Littenberg B, Colice G . The clinical evaluation for detecting metastatic lung cancer. A meta-analysis. Am J Respir Crit Care Med. 1995; 152(1):225-30. DOI: 10.1164/ajrccm.152.1.7599828. View

19.

Socinski M, Crowell R, Hensing T, Langer C, Lilenbaum R, Sandler A . Treatment of non-small cell lung cancer, stage IV: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007; 132(3 Suppl):277S-289S. DOI: 10.1378/chest.07-1381. View

20.

Martin R, Joshi J, Robbins K, Tomalty D, Bosnjakovik P, Derner M . Hepatic intra-arterial injection of drug-eluting bead, irinotecan (DEBIRI) in unresectable colorectal liver metastases refractory to systemic chemotherapy: results of multi-institutional study. Ann Surg Oncol. 2010; 18(1):192-8. DOI: 10.1245/s10434-010-1288-5. View