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Complete pathological response of unresectable liver metastases from colorectal cancer after trans-arterial chemoembolization with drug-eluting beads loaded with irinotecan (DEBIRI) and concomitant systemic FOLFOX: A case report from the FFCD 1201 trial
- Source :
- Clinics and Research in Hepatology and Gastroenterology. 39:e73-e77
- Publication Year :
- 2015
- Publisher :
- Elsevier BV, 2015.
-
Abstract
- Summary Introduction Most liver metastases from colorectal cancer (CRC) are unresectable at diagnosis. Systemic chemotherapy allows secondary surgical resection in 10 to 20% of patients. Hepatic intra-arterial treatments could enhance response and resection rate. We therefore designed a prospective phase II trial testing the transarterial chemoembolization (TACE) using drug-eluting beads loaded with irinotecan (DEBIRI) with concomitant systemic FOLFOX regimen, the FFCD 1201 trial, in patients with liver limited metastatic CRC. Case report A 48-year old patient was operated from an occlusive sigmoid adenocarcinoma. Magnetic resonance imaging showed 6 bilobar liver metastasis. The patient was considered as non-eligible for surgery initially. Patient was included in the FFCD 1201 trial and received 5 cycles of FOLFOX and 2 sessions of DEBIRI, with a quite good tolerability. Post-treatment evaluation showed a partial response and sufficient tumor shrinkage to make liver metastasis resectable. Right hepatectomy associated with wedge resection in the left liver was performed and pathological findings showed a complete pathological response (CPR). Conclusion Combination of DEBIRI with FOLFOX could increase tumor shrinkage leading to secondary resection of liver metastases from CRC. This combination may also, as shown here for the first time in a patient with unresectable LM, induce CPR of all LM, known to be associated with better outcome. Our case also emphasizes the difficulty to morphologically assess pathological response and the need for new tool to better select patients who should be resected. Further results of the FFCD 1201 trial will bring more information on this new combination therapy.
- Subjects :
- Male
medicine.medical_specialty
Organoplatinum Compounds
Combination therapy
Colorectal cancer
medicine.medical_treatment
Leucovorin
Irinotecan
Metastasis
Hepatic Artery
FOLFOX
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Prospective Studies
Chemoembolization, Therapeutic
Drug Carriers
Hepatology
business.industry
Liver Neoplasms
Remission Induction
Gastroenterology
Middle Aged
medicine.disease
Antineoplastic Agents, Phytogenic
Microspheres
Surgery
Concomitant
Camptothecin
Fluorouracil
Hepatectomy
Colorectal Neoplasms
business
medicine.drug
Wedge resection (lung)
Subjects
Details
- ISSN :
- 22107401
- Volume :
- 39
- Database :
- OpenAIRE
- Journal :
- Clinics and Research in Hepatology and Gastroenterology
- Accession number :
- edsair.doi.dedup.....5612b7b582f30dc80ed50ed301c18c68