PMID- 38201500
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240114
IS  - 2072-6694 (Print)
IS  - 2072-6694 (Electronic)
IS  - 2072-6694 (Linking)
VI  - 16
IP  - 1
DP  - 2023 Dec 22
TI  - Efficacy and Safety of Liver Chemoembolization Procedures, Combined with FOLFIRI 
      Chemotherapy, in First-Line Treatment of Metastatic Colorectal Cancer in Patients 
      with Oncogene Mutations.
LID - 10.3390/cancers16010071 [doi]
LID - 71
AB  - PURPOSE: The usual first- and second-line treatments for inoperable liver 
      metastases from colorectal cancer (CRC) involve systemic chemotherapy, often with 
      molecular targeted therapy. Chemoembolization, using microspheres loaded with 
      irinotecan, has also been available as a treatment option for many years, used 
      mainly in later lines of treatment when, due to increasing resistance, other 
      chemotherapy regimens may have been exhausted. However, when there are 
      contraindications to molecular therapies, the use of chemoembolization as first 
      or second lines of treatment, in combination with FOLFIRI chemotherapy, may 
      provide greater efficacy due to reduced irinotecan resistance. OBJECTIVE: The aim 
      of the study was to evaluate the efficacy and safety of transarterial 
      chemoembolization (DEB-TACE) procedures for the treatment of metastatic liver 
      lesions from CRC, using irinotecan-loaded microspheres as first-line treatment 
      together with FOLFIRI chemotherapy. PATIENTS AND METHODS: The analysis included 
      20 patients (12 females; 8 males) with unresectable liver metastases in the 
      course of CRC with KRAS, NRAS and BRAF mutations, who underwent 73 
      chemoembolization procedures with microspheres loaded with 100 mg of irinotecan, 
      in combination with interspersed FOLFIRI chemotherapy. Response to treatment was 
      assessed through computed tomography according to the Modified Response 
      Evaluation Criteria in Solid Tumors (mRECIST). Progression-free survival (PFS) 
      and overall survival (OS) were calculated using the Kaplan-Meier method. 
      Assessment of adverse events utilized the Cancer Therapy Evaluation Program's 
      Common Terminology Criteria for Adverse Events (CTCAE; version 5.0). RESULTS: 
      Partial remission (PR) was observed in 11 (55%) patients while 5 (25%) patients 
      showed stable disease (SD). Progression (PD) was observed in 4 (20%) patients. 
      Median PFS was 9.1 months (95% CI: 7.2-10.1 months) and median OS was 20.7 months 
      (95% CI: 18.2-23.3 months). The most common adverse events (AEs) resulting in 
      treatment delay were hematological disorders, notably neutropenia (CTCAE grades 
      1-3). No deaths or AEs above grade 3 occurred during TACE. Continued FOLFIRI 
      chemotherapy after TACE treatments resulted in grade 4 neutropenia in two 
      patients, grade 3 in four patients and grade 2 thrombocytopenia in two patients. 
      CONCLUSION: Combining FOLFIRI chemotherapy with chemoembolization procedures for 
      liver metastatic lesions from colorectal cancer may provide a valuable treatment 
      option for patients not qualified for monoclonal antibody therapy.
FAU - Szemitko, Marcin
AU  - Szemitko M
AUID- ORCID: 0000-0002-7271-7495
AD  - Department of Interventional Radiology, Pomeranian Medical University, Al. Pow. 
      Wielkopolskich 72, 70-111 Szczecin, Poland.
FAU - Falkowski, Aleksander
AU  - Falkowski A
AD  - Department of Interventional Radiology, Pomeranian Medical University, Al. Pow. 
      Wielkopolskich 72, 70-111 Szczecin, Poland.
FAU - Modrzejewska, Monika
AU  - Modrzejewska M
AUID- ORCID: 0000-0002-9221-8909
AD  - II Department of Ophthalmology, Pomeranian Medical University, Al. Pow. 
      Wielkopolskich 72, 70-111 Szczecin, Poland.
FAU - Golubinska-Szemitko, Elzbieta
AU  - Golubinska-Szemitko E
AD  - Department of General and Dental Diagnostic Imaging, Pomeranian Medical 
      University, Al. Pow. Wielkopolskich 72, 70-111 Szczecin, Poland.
LA  - eng
PT  - Journal Article
DEP - 20231222
PL  - Switzerland
TA  - Cancers (Basel)
JT  - Cancers
JID - 101526829
PMC - PMC10778126
OTO - NOTNLM
OT  - DEB-TACE
OT  - FOLFIRI
OT  - FOLFOX
OT  - irinotecan
OT  - microspheres
COIS- The authors declare no conflicts of interest.
EDAT- 2024/01/11 07:42
MHDA- 2024/01/11 07:43
PMCR- 2023/12/22
CRDT- 2024/01/11 01:06
PHST- 2023/10/27 00:00 [received]
PHST- 2023/12/08 00:00 [revised]
PHST- 2023/12/19 00:00 [accepted]
PHST- 2024/01/11 07:43 [medline]
PHST- 2024/01/11 07:42 [pubmed]
PHST- 2024/01/11 01:06 [entrez]
PHST- 2023/12/22 00:00 [pmc-release]
AID - cancers16010071 [pii]
AID - cancers-16-00071 [pii]
AID - 10.3390/cancers16010071 [doi]
PST - epublish
SO  - Cancers (Basel). 2023 Dec 22;16(1):71. doi: 10.3390/cancers16010071.