Transarterial chemoembolization (TACE) for colorectal liver metastases—current status and critical review

Maßmann, Alexander; Rodt, Thomas; Marquardt, S; Seidel, Roland; Thomas, Katrina; Wacker, Frank; Richter, G. M.; Kauczor, Hans Ulrich; Bücker, Arno; Pereira, Philippe L.; Sommer, Christof M.

doi:10.1007/s00423-015-1308-9

Cited by 62 publications

(50 citation statements)

References 101 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There are three categories of TACE: 1) conventional (cTACE), 2) degradable starch microsphere (DSM‐TACE), and 3) drug eluting bead (DEB‐TACE). In cTACE, cytotoxic chemotherapy is injected into the artery, which is then embolized with permanent agents (for example, polyvinyl alcohol particles) that are often size calibrated to target a specific arterial level . In DSM‐TACE, one or more cytotoxic agents are mixed with DSM‐TACEs, causing a temporary arterial occlusion .…”

Section: Regional Therapiesmentioning

confidence: 99%

“…DEB‐TACE combines the two methods: permanent embolic agents are coated with cytotoxic therapies allowing for a controlled release of the drug into the tissues over hours or days. Currently, this is the most standard and accepted of the TACE technologies . DEB‐TACE can be used in patients with adequate liver function in tumors without vascular invasion and has been studied in non‐resectable colorectal liver metastases and as a neo‐adjuvant therapy to downstage patients for surgical resection or ablation with objective response rates of 42% to 78% and progression‐free survival of 11 to 19 months .…”

Section: Regional Therapiesmentioning

confidence: 99%

See 1 more Smart Citation

Historical perspective: Two decades of progress in treating metastatic colorectal cancer

Lee

Cardona

Russell

2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

Colorectal cancer is the third most commonly diagnosed cancer in the United States. While screening methods strive to improve rates of early stage detection, 25% of patients have metastatic disease at the time of diagnosis, with the most common sites being the liver, lung, and peritoneum. While once perceived as hopeless, the last two decades have seen substantial strides in the medical, surgical, and regional therapies to treat metastatic disease offering significant improvements in survival.

show abstract

Section: Regional Therapiesmentioning

confidence: 99%

Section: Regional Therapiesmentioning

confidence: 99%

Historical perspective: Two decades of progress in treating metastatic colorectal cancer

Lee

Cardona

Russell

2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

“…With a focus on technical issues, for thermal ablation, homogeneous ablation zones (considering the desmoplastic growth pattern of ICC) and homogeneous safety margins of at least 1 cm (due to the ill-defined margins of ICC on computed tomography/magnetic resonance imaging/ultrasound) and for different transarterial therapies, optimization of the protocols (e.g. doses and types of chemotherapeutic agents, types and sizes of embolic agents, internal radiation dose, treatment intervals, and response evaluation) are of particular relevance [3,4,6,18]. For the future, complex multimodal concepts are the key to further improve progression-free and overall survival as well as the quality of life in patients with CC in different stages.…”

Section: Discussionmentioning

confidence: 99%

“…Additional publications were identified after crosschecking of the reference lists of the articles extracted by means of primary selection. A description of the different modalities and techniques available for locoregional therapy is not outlined in this overview; however, it can easily be obtained from other publications [1,2,3,4,5,6,7,8,9,10]. …”

Section: Introductionmentioning

confidence: 99%

Locoregional Therapies of Cholangiocarcinoma

2016

Self Cite

View full text Add to dashboard Cite

Background: Cholangiocarcinoma (CC) is the second most primary liver malignancy with increasing incidence in Western countries. Currently, surgical R0 resection is regarded as the only potentially curative treatment. The results of systemic chemotherapy and best supportive care (BSC) in patients with metastatic disease are often disappointing in regard to toxicity, oncologic efficacy, and overall survival. In current practice, the use of different locoregional therapies is increasingly more accepted. Methods: A review of the literature on locoregional therapies for intrahepatic cholangiocarcinoma (ICC) was undertaken. Results: There are no prospective randomized controlled trials. For localized ICC, either primary or recurrent, radiofrequency ablation (RFA) is by far the most commonly used thermal ablation modality. Thereby, a systematic review and meta-analysis reports major complication in 3.8% as well as 1-, 3-, and 5-year overall survival rates of 82, 47, and 24%, respectively. In selected patients (e.g. with a tumor diameter of ≤3 cm), oncologic efficacy and survival after RFA are comparable with surgical resection. For diffuse ICC, different transarterial therapies, either chemotherapy-based (hepatic artery infusion (HAI), transarterial chemoembolization (TACE)) or radiotherapy-based (transarterial radioembolization (TARE)), show extremely promising results. With regard to controlled trials (transarterial therapy versus systemic chemotherapy, BSC or no treatment), tumor control is virtually always better for transarterial therapies and very often accompanied by a dramatic survival benefit and improvement of quality of life. Of note, the latter is the case not only for patients without extrahepatic metastatic disease but also for those with liver-dominant extrahepatic metastatic disease. There are other locoregional therapies such as microwave ablation, irreversible electroporation, and chemosaturation; however, the current data support their use only in controlled trials or as last-line therapy. Conclusion: Dedicated locoregional therapies are commonly used for primary and recurrent ICC as well as liver-only and liver-dominant extrahepatic metastatic disease. Currently, the best evidence and most promising results are available for RFA, HAI, TACE, and TARE. In cohort studies, the overall survival rates are similar to those obtained with surgery or systemic therapies. Prospective randomized controlled trials are warranted to compare safety and efficacy between different surgical, interventional, and systemic therapies, as well as their combinations.

show abstract

“…We used degradable starch microsphere (DSM)-TACE with EmboCept® S (450 mg/7.5 mL; PharmaCept, Berlin, Germany) with a particle mean size of 50 µm. These particles are dissolved by human amylase and cause temporary vascular occlusion with a recanalization time of approximately 1 h [13]. No studies have shown if oxaliplatin could be mixed with EmboCept® S and therefore EmboCept® S was injected after the infusion of oxaliplatin.…”

Section: Methodsmentioning

confidence: 99%

Intrahepatic Oxaliplatin and Systemic 5-FU +/– Cetuximab in Chemo-Naïve Patients with Liver Metastases from Colorectal Cancer

et al. 2019

View full text Add to dashboard Cite

Background: In case of response to chemotherapy, unresectable liver metastases from colorectal cancer can be converted to resectable and thereby obtain a chance of cure. The primary aim of this trial was to evaluate the response rate with intrahepatic oxaliplatin in combination with systemic 5-FU +/– cetuximab. Secondary aims were to evaluate the conversion rate from unresectable to resectable liver metastases, median progression-free survival, median overall survival, and toxicity. Methods: Forty-five chemo-naïve patients with liver metastases from colorectal cancer were treated in a prospective phase II trial. Calcium folinate and 5-FU were delivered systemically while oxaliplatin was delivered alternating between systemic and intrahepatic administration. When oxaliplatin was delivered intrahepatically, infusion time was reduced to 10 min followed by embolic material. In patients with KRAS wild-type tumors, cetuximab was added. Results: The treatment was well tolerated and only pain in the liver and a mild increase in liver enzymes were observed after intrahepatic oxaliplatin. The patients obtained a response rate of 82%. Further, 58% converted from having unresectable to resectable liver metastases. The median overall survival and progression-free survival were 38.7 months (95% confidence interval [CI] 33.0–44.3) and 12.9 months (95% CI 10.2–15.6), respectively. Conclusions: Intrahepatic infusion of oxaliplatin in 10 min with systemic 5-FU to patients with chemo-naïve colorectal cancer is feasible and with low toxicity. A high response rate and long median overall survival were obtained.

show abstract

Transarterial chemoembolization (TACE) for colorectal liver metastases—current status and critical review

Cited by 62 publications

References 101 publications

Historical perspective: Two decades of progress in treating metastatic colorectal cancer

Historical perspective: Two decades of progress in treating metastatic colorectal cancer

Locoregional Therapies of Cholangiocarcinoma

Intrahepatic Oxaliplatin and Systemic 5-FU +/– Cetuximab in Chemo-Naïve Patients with Liver Metastases from Colorectal Cancer

Contact Info

Product

Resources

About