A treatment for patients with advanced colorectal cancer that has
spread to the liver has been found to increase life expectancy, said
Dr. Nancy Kemeny, an oncologist at Memorial Sloan-Kettering Cancer
Center. This treatment combines traditional chemotherapy with
medication delivered through a surgically implanted pump.
A combined therapy study evaluated 156 patients with colorectal
cancer who had undergone surgery to remove tumors that had spread to
the liver. The results were presented at the 35th annual meeting of
the American Society of Clinical Oncology (ASCO).
Combined Therapy Increases Survival and Decreases Liver Recurrences
One group of colorectal cancer patients treated with standard
systemic chemotherapy was compared to a second group treated with a
combination of systemic chemotherapy and hepatic arterial infusion.
The researchers found that the combined treatment significantly
increased 2-year survival rates and decreased the recurrence of
tumors that had spread to the liver in patients with metastatic
Our results show that combining these two treatment approaches
provides a more effective way to treat colorectal cancer patients who
have had surgery to remove tumors that have spread to the liver,
said Dr. Kemeny. Not only did these patients live longer than
those treated with traditional systemic chemotherapy, but they had
significantly less recurrence of disease in the liver.
Previous research showed that surgery to remove tumors from the liver
offered the best chance of cure for patients whose colon cancer had
spread. Unfortunately, many of these patients had tumors that could
not be removed surgically. Moreover, about 65% of patients who had
operable tumors were still living at 2 years, while only 25% remained
free of a recurrence of disease in the liver.
To determine whether systemic chemotherapy could be improved to
increase survival rates, a continuous infusion of floxuridine (FUDR)
and dexamethasone were added to the systemic chemotherapy drug
regimen of flurorouracil (5-FU) and leucovorin for 6 months. Since
FUDR is readily absorbed in the liver, the patients tolerated higher
doses of the chemotherapeutic drugs with less side effects.
Results of the studies showed 85% of patients receiving the combined
therapy after surgery to remove liver metastases survived longer than
2 years compared to 69% of patients receiving only systemic
chemotherapy. Moreover, 89% of the colorectal patients who were
treated with the combined therapy had no recurrence of tumors in the
liver, as compared with 57% of patients treated with systemic chemotherapy.
These results are impressive as this is the first study to show
an increase in survival with treatment after surgery to remove
metastasis in the liver, said Dr. Kemeny. Researchers plan to
continue clinical trials combining different drug regimens
administered via the implantable pump technology.