Intra-arterial Therapy of Hepatic Metastases

Abstract

There are several unique aspects of hepatic arterial chemotherapy, making it a treatment modality that is both rational and of great therapeutic potential (Table 1). Recent developments have defined the prerequisites for successful hepatic arterial chemotherapy and provided the methods for achieving those prerequisites (Table 2)^{(1, 2)}. The development of the totally implanted drug delivery system, its successful application in several large phase II studies in colorectal liver metastases, and the FDA approval for commercial sale of the Model 400 Infusaid pump (Infusaid Corp., Norwood, MA) have provided a major impetus to the entire field of regional chemotherapy. The phase II studies of note are from the University of Michigan and the University of Alabama, and both have been recently published in detail ^(3,4).Thus, this discussion will only summarize these results and describe the problems in their interpretation and in performing the essential randomized phase III studies.