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 colorectal cancer.
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(Drug information on 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.