Hepatic Arterial Infusion for Unresectable Liver Metastases from Colorectal Cancer: The Dawn of a New Era?

Excerpt

Nearly 10 years ago, authors of a meta-analysis examining the effectiveness of hepatic arterial infusion (HAI) chemotherapy for patients with unresectable colorectal liver metastases (CRLM) concluded that it was “the end of an era.”1 Although patients treated with HAI achieved an impressive improvement in their tumor response rate (43 vs. 18 %), no benefit was seen in the ultimate patient-important outcome of overall survival (OS). Despite the provocative title, the role of HAI for patients with unresectable CRLM continued to be explored at a handful of high-volume, specialized centers. Recent reports of excellent long-term outcomes from patients treated at the Memorial Sloan-Kettering Cancer Center (MSKCC) and the University of Pittsburgh Medical Center (UPMC) suggest that HAI may indeed provide important benefit for selected patients with unresectable CRLM, even in an era of better systemic therapy.2,3 …