Triple Therapy for Liver Troubles

Liver metastasis treatment with irinotecan 5 fluorouracil and oxaliplatin phase II trial

(RxWiki News) Finding that your cancer has metastasized can make it hard to stay hopeful, but hard-hitting new treatment for colorectal cancer tumors that have turned up in the liver has shown good results.

Doctors designing the study tested several concepts at once, adding more drugs to current treatment, focused on aggressive use of surgery when possible, and injected the chemotherapy directly into the liver for maximum delivery.

"Ask your doctor about side effects from chemotherapy."

In their presentation, at the American Society of Clinical Oncology, a research team based in France concluded that the triple therapy of Camptosar (irinotecan), Adrucil (5-fluorouracil) and Eloxatin (oxaliplatin) was a safe and effective option for patients with colorectal cancer metastasis in the liver, even in patients that had not responded to previous chemotherapy.

The study showed that the combination of these three drugs shrunk the liver tumors enough to make surgical removal an option in 15 of the 48 patients.

The specialized treatment combination included chemotherapy injected directly to the hepatic artery to increase exposure of the liver to the drugs, and this study describes one of the few drug trials for metastasis that involves surgery as a key part of the treatment.

By following a cycle of chemotherapy with surgery, which is referred to as neoadjuvant chemotherapy, the surgery is made easier since the tumors are smaller. More importantly, undetectable tiny areas of metastasis are likely to be destroyed, and it is less likely that any cancer remains afterwards.

The response was fairly good considering the challenges of treating these advanced cancers. Of the 48 patients, 21 showed response to the treatment, and three patients had no detectable tumors under imaging at the end of the trial.

Overall, the triple chemotherapy treatment showed an ability to reduce the size of the tumors in 41 of the 48 patients in the trial.

Follow up after treatment continued for 47 months, with researchers documenting an average (the median) of 14 months until the cancer growth began anew, and the one year survival included 45 out of the 48 patients.

Impressively, one patient in the trial had complete remission of her 25 different liver tumors and is no longer under treatment, and still had no signs of cancer 17 months later.

Former studies using Eloxatin in colorectal cancers have shown overall longer times before tumor growth, high response rates, and few side effects.

Eloxatin, also known as Oxaliplatin Medac, was approved by the U.S. Food and Drug Administration (FDA) in 2002.

Common side effects that were documented during the trial included lowered amounts of immune cells, reversible nerve damage, fatigue, nausea, vomiting, and diarrhea which are symptoms consistent with the use of platinum-based chemotherapy drugs.

Presentations at medical conferences should be considered preliminary until findings are published in a peer-reviewed journal.

The research team had no financial conflicts of interests to disclose.

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Review Date: 
June 21, 2012