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Regional chemotherapy for colorectal hepatic metastases: Evidence for improved survival with new drug combinations

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Abstract

Background: In patients with colorectal hepatic metastases, response rates with hepatic arterial infusion (HAI) FUdR (5-Fluoro-2-deoxyuridine) are significantly higher than with systemic fluoropyrimidines. We report a novel animal model of intrahepatic therapy for hepatic metastasis for the study of methods to increase response rates and improve survival.

Methods: BD-IX rats are injected intrasplenically with K12/TRb cells. When hepatic metastases are established, animals are treated with hepatic or systemic chemotherapy, and the response to treatment, survival, and cause of death is determined.

Results: Significant responses were observed with low- and high-dose HAI FUdR (p=0.03 and 0.001, respectively). Only high-dose FUdR controlled hepatic disease. HAI FUdR alone did not prolong survival compared with control, but combination systemic FUdR and HAI FUdR did (p=0.04). Continuous HAI of either 5-fluorouridine or mitomycin C has not previously been reported. There was no significant difference in response to FUdR, 5-fluorouridine, or mitomycin C. However, combination HA bolus mitomycin C plus either HAI 5-fluorouridine or HAI mitomycin C showed synergy with improved survival compared with all other treatment groups (p<0.0001).

Conclusions: The combination of bolus hepatic artery mitomycin C with either HAI mitomycin C or HAI 5-fluorouridine yields significant response rates, and survival is improved by this novel combination therapy.

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References

  1. Coller FA. In: Ransom HK, Regan WJ, eds.Cancer of the colon and rectum. New York: American Cancer Society, 1956:3–4.

    Google Scholar 

  2. Chen HSG, Gross JF. Intra-arterial infusion of anti-cancer drugs: theoretic aspects of drug delivery and review of responses.Cancer Treat Rep 1980;64:31–40.

    CAS  PubMed  Google Scholar 

  3. Breedis C, Young C. The blood supply of neoplasms in the liver.Am J Pathol 1954;30:969.

    CAS  PubMed  Google Scholar 

  4. Cohen A, Schaeffer N, Higgins J. Treatment of metastatic colorectal cancer with hepatic artery combination chemotherapy.Cancer 1986;57:1115–7.

    CAS  PubMed  Google Scholar 

  5. Sigurdson ER, Ridge JA, Kemeny N, Daly JM. Tumor and liver drug uptake following hepatic artery and portal vein infusion.J Clin Oncol 1987;5:1936–40.

    Google Scholar 

  6. Kemeny N. Is hepatic infusion of chemotherapy effective for liver metastases? Yes! In: DeVita VT, Hellman S, Rosenberg S, Rosenberg S, eds.Important advances in oncology. Philadelphia: JB Lippincott, 1992:207–27.

    Google Scholar 

  7. Kemeny N, Daly J, Reichman B, Geller N, Botet J, Oderman P. Intrahepatic or systemic infusion of fluorodeoxyuridine in patients with liver metastases from colorectal carcinoma.Ann Intern Med 1987;107:459–65.

    CAS  PubMed  Google Scholar 

  8. Martin MS, Martin F, Michiels R, et al. An experimental model for cancer of the colon and rectum.Digestion 1973;8:22–34.

    CAS  PubMed  Google Scholar 

  9. House AK, Maley MAL. Clinical and in vivo response following surgery or surgery plus adjuvant chemotherapy or immunotherapy for colorectal carcinoma in a rat model.J R Soc Med 1983;76:833–46.

    CAS  PubMed  Google Scholar 

  10. Martin F, Caignard A, Jeannin JF, Leclerc A, Martin M. Selection by trypsin of two sublines of rat colon cancer cells forming progressive or regressive tumors.Int J Cancer 1983;32:623–7.

    CAS  PubMed  Google Scholar 

  11. Marquet RL, Westbroek DL, Jeekel J. Interferon treatment of a transplantable rat colon adenocarcinoma: importance of tumor site.Int J Cancer 1984;33:689–92.

    CAS  PubMed  Google Scholar 

  12. Suto A, Kubota T, Shimoyama Y, Ishibiki K, Abe O. MTT assay with reference to the clinical effect of chemotherapy.J Surg Oncol 1989;42:28–32.

    CAS  PubMed  Google Scholar 

  13. van der Elst J, De Greve J, Geerts F, De Neve W, Storme G, Willems G. Quantitative study of liver metastases from colon cancer in rats after treatment with cyclosporin A.J Natl Cancer Inst 1986;77:227–31.

    PubMed  Google Scholar 

  14. van Dale P, Galand P. Effect of partial hepatectomy on experimental liver invasion by intraportally injected colon carcinoma cells in rats.Invasion Metastasis 1988;8:217–27.

    PubMed  Google Scholar 

  15. Archer SG, Gray BN. Comparison of portal vein chemotherapy with hepatic artery chemotherapy in the treatment of liver micrometastases.Am J Surg 1990;159:325–9.

    CAS  PubMed  Google Scholar 

  16. Kemeny N, Conti J, Sigurdson E, et al. A pilot study of hepatic artery floxuridine combined with systemic 5-fluorouracil and leucovorin.Cancer 1993;71:1964–71.

    CAS  PubMed  Google Scholar 

  17. Wilkinson DS, Pitot HC. Inhibition of ribosomal ribonucleic acid maturation in Novikoff hepatoma cells by 5-fluorouracil and 5-fluorouridine.J Biol Chem 1973;248:63–8.

    CAS  PubMed  Google Scholar 

  18. Wilkinson DS, Tisty TD, Hanas RJ. The inhibition of ribosomal RNA synthesis and maturation in Novikoff hepatoma cells by 5-fluorouridine.Cancer Res 1975;35:3014–20.

    CAS  PubMed  Google Scholar 

  19. Currie VE, Burchenal JH, Sykes MP, Clarkson BD, Krakoff IH. Animal and clinical studies of 5-fluorouridine.Proc AACR ASCO 1975;16:188.

    Google Scholar 

  20. Anukarahanonta T, Holstege A, Keppler D. Selective enhancement of 5-fluorouridine uptake and action in rat hepatomas in vivo following pretreatment with D-galactosamine and 6-azauridine or N-(phosphonacetyl)-L-aspartate.Eur J Cancer 1980;16:1171–80.

    CAS  PubMed  Google Scholar 

  21. Pausch J, Holstege A, Anukarahanonta T, Keppler D, Gerok W. First clinical experiences with a selective chemotherapy of hepatocellular carcinoma with 5-fluorouridine in combination with other antipyrimidines.Adv Enzyme Regul 1985;24:429–32.

    CAS  PubMed  Google Scholar 

  22. Kemeny N, Cohen A, Seiter K, Conti J, Sigurdson E. Randomized trial of hepatic arterial floxuridine, mitomycin, and carmustine versus floxuridine alone in previously treated patients with liver metastases from colorectal cancer.J Clin Oncol 1993;11:330–5.

    CAS  PubMed  Google Scholar 

  23. Atiq O, Kemeny N, Niedzweiki D, Botet J. Treatment of unresectable primary liver cancer with intrahepatic fluorodeoxyuridine and mitimycin C through an implantable pump.Cancer 1992;69:920–24.

    CAS  PubMed  Google Scholar 

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Sutanto-Ward, E., Arisawa, Y., Tremiterra, S. et al. Regional chemotherapy for colorectal hepatic metastases: Evidence for improved survival with new drug combinations. Annals of Surgical Oncology 3, 36–43 (1996). https://doi.org/10.1007/BF02409049

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