
pmid: 30544058
Hepatic arterial treatment (HAT) for liver metastases in patients with metastatic breast cancer (MBC) has only been investigated in few studies.Two phase II trials were initiated simultaneously to evaluate capecitabine in combination with oxaliplatin in patients with MBC and liver metastases. These two trials are reported together. Continuous capecitabine (1300 mg/m2) was combined with oxaliplatin (85 mg/m2) alternating between systemic treatment and HAT followed by degradable starch microspheres with EmboCept® S every second week. Four patients participated in a pharmacokinetic analysis of oxaliplatin. Each patient had samples taken when receiving oxaliplatin systemically and as HAT with and without EmboCept® S.Totally, 52 patients received HAT: 14 with liver metastases only and 38 patients with additional limited metastatic disease. The patients had previously received a median of 2 (range 0-6) chemotherapeutic regimens for MBC. The response rate was 42.3% (95% confidence interval (CI) 28.7-56.8%) with 7.7% complete and 34.6% partial responses. Median progression free survival was 10.8 months (95% CI 6.9-14.7 months) and median overall survival 27.6 months (95% CI 20.4-34.8 months). The toxicity was moderate with hand-foot syndrome (15.4%), neuropathy (9.6%), fatigue (9.6%), and abdominal pain (9.6%) being the most common grade 3 adverse events. There was no clear difference between systemic blood concentrations of oxaliplatin when given systemic or as HAT.HAT oxaliplatin in combination with capecitabine is safe and efficient in patients with MBC. The results are promising with high response rates and a long median progression free and overall survival.
Adult, Breast Neoplasms/pathology, Peripheral Nervous System Diseases/chemically induced, Breast Neoplasms, Adenocarcinoma, Oxaliplatin/administration & dosage, Hepatic Artery, Adenocarcinoma/secondary, Antineoplastic Combined Chemotherapy Protocols, Humans, Chemoembolization, Therapeutic, Capecitabine, Fatigue, Aged, Liver Neoplasms, Peripheral Nervous System Diseases, Middle Aged, Progression-Free Survival, Abdominal Pain, Oxaliplatin, Hand-Foot Syndrome/etiology, Capecitabine/administration & dosage, Liver Neoplasms/secondary, Fatigue/chemically induced, Abdominal Pain/chemically induced, Chemoembolization, Female, Hand-Foot Syndrome, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Therapeutic/methods
Adult, Breast Neoplasms/pathology, Peripheral Nervous System Diseases/chemically induced, Breast Neoplasms, Adenocarcinoma, Oxaliplatin/administration & dosage, Hepatic Artery, Adenocarcinoma/secondary, Antineoplastic Combined Chemotherapy Protocols, Humans, Chemoembolization, Therapeutic, Capecitabine, Fatigue, Aged, Liver Neoplasms, Peripheral Nervous System Diseases, Middle Aged, Progression-Free Survival, Abdominal Pain, Oxaliplatin, Hand-Foot Syndrome/etiology, Capecitabine/administration & dosage, Liver Neoplasms/secondary, Fatigue/chemically induced, Abdominal Pain/chemically induced, Chemoembolization, Female, Hand-Foot Syndrome, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Therapeutic/methods
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