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Published in: CardioVascular and Interventional Radiology 6/2020

01-06-2020 | Metastasis | Clinical Investigation

Does Bead Size Affect Patient Outcome in Irinotecan-Loaded Beads Chemoembolization Plus Systemic Chemotherapy Regimens for Liver-Dominant Colorectal Cancer? Results of an Observational Study

Authors: Tom Boeken, Nadia Moussa, Simon Pernot, Abdellahi Abed, Carole Dean, Julien Taieb, Marc Sapoval, Olivier Pellerin

Published in: CardioVascular and Interventional Radiology | Issue 6/2020

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Abstract

Purpose

We investigated the clinical effects of bead size in irinotecan-loaded beads chemoembolization (DEBIRI) used for treating liver-dominant colorectal cancer.

Materials and Methods

Between March 2009 and January 2018, all consecutive patients with colorectal cancer liver metastases referred for DEBIRI at our tertiary center were included in an observational study. Patients were treated exclusively with either 100-mg irinotecan-loaded DC beads of 70–150 μm (small bead group or SB) or 100–300 μm (large bead group or LB) in diameter, in addition to systemic therapy. Liver tumor response rate at 3 months, liver and overall progression-free survival (PFS) and overall survival were estimated.

Results

In total, 84 patients with liver-dominant progressive disease underwent 232 DEBIRI sessions. Fifty-four patients were treated in the SB group and 30 patients in the LB group. Liver progression-free rates at 3 months were 86.7% for the LB group and 79.6% for the SB group (NS). Median liver-PFS and overall PFS were, respectively, 7.15 months and 7.15 months for the LB group and 7.65 and 7.55 months for the SB group (NS). Median overall survival was 13.04 months for the LB group and 15.59 months for the SB group (p = 0.04). Specific treatment grade 3 + 4 toxicity occurrence was 5 (17%) in the LB group and 20 (37%) in the SB group.

Conclusion

No significant difference in patient outcome was observed between DEBIRI bead sizes of 70–150 μm and 100–300 μm. A trend toward higher treatment-specific toxicity was observed with the smaller beads.
Literature
2.
go back to reference Shah MA, Renfro LA, Allegra CJ, Andre T, de Gramont A, Schmoll HJ, Haller DG, Alberts SR, Yothers G, Sargent DJ. Impact of patient factors on recurrence risk and time dependency of oxaliplatin benefit in patients with colon cancer: analysis from modern-era adjuvant studies in the adjuvant colon cancer end points (ACCENT) database. J Clin Oncol. 2016;34(8):843–53. https://doi.org/10.1200/JCO.2015.63.0558.CrossRefPubMedPubMedCentral Shah MA, Renfro LA, Allegra CJ, Andre T, de Gramont A, Schmoll HJ, Haller DG, Alberts SR, Yothers G, Sargent DJ. Impact of patient factors on recurrence risk and time dependency of oxaliplatin benefit in patients with colon cancer: analysis from modern-era adjuvant studies in the adjuvant colon cancer end points (ACCENT) database. J Clin Oncol. 2016;34(8):843–53. https://​doi.​org/​10.​1200/​JCO.​2015.​63.​0558.CrossRefPubMedPubMedCentral
5.
go back to reference Yoshino T, Arnold D, Taniguchi H, Pentheroudakis G, Yamazaki K, Xu RH, Kim TW, Ismail F, Tan IB, Yeh KH, Grothey A, Zhang S, Ahn JB, Mastura MY, Chong D, Chen LT, Kopetz S, Eguchi-Nakajima T, Ebi H, Ohtsu A, Cervantes A, Muro K, Tabernero J, Minami H, Ciardiello F, Douillard JY. Pan-Asian adapted ESMO consensus guidelines for the management of patients with metastatic colorectal cancer: a JSMO-ESMO initiative endorsed by CSCO, KACO, MOS, SSO and TOS. Ann Oncol. 2018;29(1):44–70. https://doi.org/10.1093/annonc/mdx738.CrossRefPubMed Yoshino T, Arnold D, Taniguchi H, Pentheroudakis G, Yamazaki K, Xu RH, Kim TW, Ismail F, Tan IB, Yeh KH, Grothey A, Zhang S, Ahn JB, Mastura MY, Chong D, Chen LT, Kopetz S, Eguchi-Nakajima T, Ebi H, Ohtsu A, Cervantes A, Muro K, Tabernero J, Minami H, Ciardiello F, Douillard JY. Pan-Asian adapted ESMO consensus guidelines for the management of patients with metastatic colorectal cancer: a JSMO-ESMO initiative endorsed by CSCO, KACO, MOS, SSO and TOS. Ann Oncol. 2018;29(1):44–70. https://​doi.​org/​10.​1093/​annonc/​mdx738.CrossRefPubMed
7.
go back to reference Pernot S, Artru P, Tougeron D, Montérymard C, Smith D, De La Fouchardière C, Raoul J-L, Dahan L, Guimbaud R, Michel P, Jouve J-L, Pellerin O, Taieb J. 461PDFolfox and intra-arterial DEBIRI as front-line treatment in patients with non resectable colorectal cancer liver metastases (FFCD 1201 phase II trial). Ann Oncol. 2018. https://doi.org/10.1093/annonc/mdy281.009.CrossRefPubMed Pernot S, Artru P, Tougeron D, Montérymard C, Smith D, De La Fouchardière C, Raoul J-L, Dahan L, Guimbaud R, Michel P, Jouve J-L, Pellerin O, Taieb J. 461PDFolfox and intra-arterial DEBIRI as front-line treatment in patients with non resectable colorectal cancer liver metastases (FFCD 1201 phase II trial). Ann Oncol. 2018. https://​doi.​org/​10.​1093/​annonc/​mdy281.​009.CrossRefPubMed
8.
go back to reference Jones RP, Malik HZ, Fenwick SW, Terlizzo M, O’Grady E, Stremitzer S, Gruenberger T, Rees M, Plant G, Figueras J, Albiol M, Adam R, Awad S, Poston GJ. PARAGON II - A single arm multicentre phase II study of neoadjuvant therapy using irinotecan bead in patients with resectable liver metastases from colorectal cancer. Eur J Surg Oncol. 2016;42(12):1866–72. https://doi.org/10.1016/j.ejso.2016.07.142.CrossRefPubMed Jones RP, Malik HZ, Fenwick SW, Terlizzo M, O’Grady E, Stremitzer S, Gruenberger T, Rees M, Plant G, Figueras J, Albiol M, Adam R, Awad S, Poston GJ. PARAGON II - A single arm multicentre phase II study of neoadjuvant therapy using irinotecan bead in patients with resectable liver metastases from colorectal cancer. Eur J Surg Oncol. 2016;42(12):1866–72. https://​doi.​org/​10.​1016/​j.​ejso.​2016.​07.​142.CrossRefPubMed
11.
go back to reference Aliberti C, Tilli M, Benea G, Fiorentini G. Trans-arterial chemoembolization (TACE) of liver metastases from colorectal cancer using irinotecan-eluting beads: preliminary results. Anticancer Res. 2006;26(5B):3793–5.PubMed Aliberti C, Tilli M, Benea G, Fiorentini G. Trans-arterial chemoembolization (TACE) of liver metastases from colorectal cancer using irinotecan-eluting beads: preliminary results. Anticancer Res. 2006;26(5B):3793–5.PubMed
13.
go back to reference Fiorentini G, Aliberti C, Tilli M, Mulazzani L, Graziano F, Giordani P, Mambrini A, Montagnani F, Alessandroni P, Catalano V, Coschiera P. Intra-arterial infusion of irinotecan-loaded drug-eluting beads (DEBIRI) versus intravenous therapy (FOLFIRI) for hepatic metastases from colorectal cancer: final results of a phase III study. Anticancer Res. 2012;32(4):1387–95.PubMed Fiorentini G, Aliberti C, Tilli M, Mulazzani L, Graziano F, Giordani P, Mambrini A, Montagnani F, Alessandroni P, Catalano V, Coschiera P. Intra-arterial infusion of irinotecan-loaded drug-eluting beads (DEBIRI) versus intravenous therapy (FOLFIRI) for hepatic metastases from colorectal cancer: final results of a phase III study. Anticancer Res. 2012;32(4):1387–95.PubMed
22.
go back to reference Martin RC, Joshi J, Robbins K, Tomalty D, Bosnjakovik P, Derner M, Padr R, Rocek M, Scupchenko A, Tatum C. Hepatic intra-arterial injection of drug-eluting bead, irinotecan (DEBIRI) in unresectable colorectal liver metastases refractory to systemic chemotherapy: results of multi-institutional study. Ann Surg Oncol. 2011;18(1):192–8. https://doi.org/10.1245/s10434-010-1288-5.CrossRefPubMed Martin RC, Joshi J, Robbins K, Tomalty D, Bosnjakovik P, Derner M, Padr R, Rocek M, Scupchenko A, Tatum C. Hepatic intra-arterial injection of drug-eluting bead, irinotecan (DEBIRI) in unresectable colorectal liver metastases refractory to systemic chemotherapy: results of multi-institutional study. Ann Surg Oncol. 2011;18(1):192–8. https://​doi.​org/​10.​1245/​s10434-010-1288-5.CrossRefPubMed
Metadata
Title
Does Bead Size Affect Patient Outcome in Irinotecan-Loaded Beads Chemoembolization Plus Systemic Chemotherapy Regimens for Liver-Dominant Colorectal Cancer? Results of an Observational Study
Authors
Tom Boeken
Nadia Moussa
Simon Pernot
Abdellahi Abed
Carole Dean
Julien Taieb
Marc Sapoval
Olivier Pellerin
Publication date
01-06-2020
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 6/2020
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-020-02438-0

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