Cancer Advances: Chemotherapy Given Directly to the Liver Improves Survival for Patients with Colorectal Cancer That Has Spread to the Liver

Posted online February 27, 2006 on www.jco.orgRead the original studyA new study shows that patients whose colorectal cancer has spread to the liver who received hepatic arterial infusion (HAI)—the administration of chemotherapy directly to the liver through a pump in the abdomen—fare better than those who received traditional, intravenous chemotherapy. Researchers found that the patients on the HAI therapy lived longer and had better quality of life than those receiving systemic therapy. The study will be published online February 27 in the Journal of Clinical Oncology.The study was conducted by two collaborative research groups—the Cancer and Leukemia Group B and the Eastern Cooperative Oncology Group—and involved patients at several research institutions.Approximately 60% of the 145,000 patients in the United States each year who develop metastatic colorectal cancer (the spread of cancer to other parts of the body) will develop metastases to their liver. Most patients with these liver tumors eventually die of their disease.In the study, patients were randomly assigned to receive either the HAI treatment using a chemotherapy pump or traditional chemotherapy given through an IV. Patients who received HAI treatment lived an average of 24 months, compared with 20 months for patients who had traditional chemotherapy. Patients in the HAI group also had greater reduction in their tumor size, and experienced a better quality of life.In addition, HAI patients did not experience the side effects commonly seen in patients who undergo traditional chemotherapy, such as diarrhea, decreased white blood cell counts, and hair loss. They did, however, need to have their liver functions more closely monitored for problems that sometimes occurred.The research began in 1996 before chemotherapy drugs such as irinotecan and oxaliplatin were available. Researchers noted that studies are currently underway using HAI therapy in combination with newer drugs, and response rates appear to be significantly higher.What Does This Mean For Patients?For patients whose colorectal cancer has spread to the liver, these findings indicate that receiving chemotherapy through a surgically inserted pump rather than intravenously results in longer survival and fewer side effects. However, not all patients are candidates for this type of pump because of the stage of their cancer or other health problems.Patients with colorectal cancer that has spread to the liver should talk with their physicians about potential treatment options, including whether HAI therapy is an appropriate treatment for their disease.Helpful LinksFor more information on the diagnosis and treatment of colorectal and liver cancer including staging illustrations, visit www.plwc.org/colorectal and www.plwc.org/liver.