Real-life multidisciplinary treatment for unresectable colorectal cancer liver metastases including hepatic artery infusion with chemo-filtration and liquid biopsy precision oncotherapy: observational cohort study

摘要: Hepatic artery infusion (HAI) and drug selection by liquid biopsy precision oncotherapy are under investigation for the multidisciplinary treatment of unresectable colorectal liver metastases (CRCLM) in progression after systemic therapy. Here, we compare safety efficacy third-line HAI followed target therapy with regimes selected to partly tissue oncotherapy, a retrospective real-life study 106 CRCLM patients. Drug regimens HAI/target were assessing sensitivity purified circulating tumor cell (CTCs) 5-fluorouracil, carboplatin, cisplatin, oxaliplatin, irinotecan, doxorubicin, mitomycin, raltitrexed, melphalan in-vitro real-time qRT-PCR gene expression assays, Systemic cohort age, comorbidity, performance status, absence RAS mutations. Therapeutic responses, adverse events, quality life evaluated RECIST 1.1, CTCAE 4.03, ECOG criteria, respectively, chemo-filtration performed following reduce toxic effects. drugs (44 patients), resulted 2.27% CRs, 38.63% PRs, 56.81% SD,s PDs; 2 1 improvement, but no infusion-related technical or vascular complications, deaths. (62 patients) 1.6% 17.74% 37.09% SDs, 45.16% more grade 1–2 events 4.84% worsening. The median 5 month PFS was significantly longer than 3 months (P < 0.007) 14 month survival 8.5 months not statistically significant. Multivariate analysis identified as most unfavourable prognostic factor both cohorts. plus therapy, is safe efficacious alternative therapeutic strategy two lines should be considered multicentre prospective phase III study, fully confirm this potential.