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Regional Chemotherapy of Primary and Metastatic Liver Tumors

  • Chapter
Book cover Regional Cancer Therapy

Part of the book series: Cancer Drug Discovery and Development ((CDD&D))

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Abstract

The rationale for hepatic arterial infusion of chemotherapy is based on the concept that most primary and metastatic liver tumors preferentially derive their blood supply from the hepatic artery, whereas normal hepatic tissue relies on the portal venous blood supply. In addition, the ability of the hepatic parenchyma to metabolize chemotherapy drugs to nontoxic metabolites offers a unique opportunity to administer highly toxic drug levels to tumor cells while minimizing systemic toxicity. Regional chemotherapy has been evaluated in both primary and metastatic hepatic malignancies with varying results. The area of most intensive research has been in the treatment of colorectal cancer because it represents the most frequent etiology of hepatic metastases. Although the response rate with newer agents used in systemic combination chemotherapy has improved, the 2-year survival is only 25 to 39%. Hepatic-arterial infusion of chemotherapy produces higher response rates, with a 2-yr survival of 50 to 60%. In patients who can undergo liver resection followed by hepatic-arterial infusion, the 2-yr survival is 85%. This chapter summarizes the pharmacological basis and technical aspects of hepatic arterial infusion, including catheter placement, infusion regimens, and the development and treatment of unique toxicities. In addition, it will review the current evidence and role of hepatic arterial infusion for all primary and secondary hepatic malignancies, with a focus on liver metastases from colorectal cancer, as this is the area of most experience and promise.

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Authors and Affiliations

  1. Memorial Sloan-Kettering Cancer Center, New York, NY

    Rebecca Taylor MD & James Tomlinson MD

  2. Department of Medical Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY

    Nancy Kemeny MD

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  1. Rebecca Taylor MD
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  2. James Tomlinson MD
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  3. Nancy Kemeny MD
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Editor information

Editors and Affiliations

  1. Robert-Rössle-Hospital and Tumor Institute, Charité University of Medicine, Berlin

    Peter M. Schlag MD (Professor and Head of Surgical Oncology) (Professor and Head of Surgical Oncology)

  2. Max-Delbrück-Center for Molecular Medicine, Berlin, Germany

    Peter M. Schlag MD (Professor and Head of Surgical Oncology) & Ulrike Stein PhD (Assistant Professor) (Professor and Head of Surgical Oncology) &  (Assistant Professor)

  3. Tumor Metastasis and Therapy Response Program, Robert-Rössle-Hospital and Tumor Institute, Charité University of Medicine, Berlin

    Ulrike Stein PhD (Assistant Professor) (Assistant Professor)

  4. Erasmus University MC—Daniel den Hoed Cancer Center, Rotterdam, The Netherlands

    Alexander M. M. Eggermont MD, PhD (Professor and Head of Surgical Oncology) (Professor and Head of Surgical Oncology)

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Taylor, R., Tomlinson, J., Kemeny, N. (2007). Regional Chemotherapy of Primary and Metastatic Liver Tumors. In: Schlag, P.M., Stein, U., Eggermont, A.M.M. (eds) Regional Cancer Therapy. Cancer Drug Discovery and Development. Humana Press. https://doi.org/10.1007/978-1-59745-225-0_13

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  • DOI: https://doi.org/10.1007/978-1-59745-225-0_13

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