Bathing liver tumors in chemotherapy increases survival, according to a Phase III trial reported at the Symposium on Clinical Interventional Oncology (CIO), in collaboration with the International Symposium on Endovascular Therapy (ISET). Minimally invasive chemosaturation delivers high doses of chemotherapy into the liver to more effectively battle tumors while limiting toxicity to the rest of the body, the researchers said.
In the multicenter randomized trial, patients with melanoma that had spread to the liver who underwent percutaneous hepatic perfusion (PHP) survived four times longer before the disease progressed, compared with patients who did not receive the treatment.
The study included 93 patients: 44 received PHP and 49 had standard treatment (typically systemic chemotherapy). In the latter group, 27 patients began receiving PHP when their disease progressed. Patients in the PHP group averaged 186 days before the disease progressed compared with 46 days for patients who did not receive PHP.
Those in the PHP group benefitted from an average of 245 days without progression of cancer in the liver vs only 49 days for those in the standard treatment group, a five-fold increase.
“The minimally invasive method isolates the drug so it is contained within the liver, where tumors receive up to 100 times the dose they would get through systemic chemotherapy,” said Charles Nutting, DO, FSIR, an interventional radiologist at Swedish Medical Center in Denver.
“There are very limited therapeutic options for these patients. This minimally invasive therapy technology could eventually be used to treat other liver cancers when options are limited.”
PHP involves delivering chemotherapy via an arterial catheter threaded through the blood vessels to the liver. Two balloons are inflated in the vena cava, above and below the liver to isolate the chemotherapy. This chemotherapy saturated blood is then cleansed by a series of filters and returned to the body. PHP allows the entire liver to be treated, which is beneficial in patients with more than one tumor.