Treating primary liver cancer with hepatic arterial infusion of floxuridine and dexamethasone: Does the addition of systemic bevacizumab improve results?

Unresectable intrahepatic cholangiocarcinoma: Systemic plus hepatic arterial infusion chemotherapy is associated with longer survival in comparison with systemic chemotherapy alone

“…Patients with unresectable disease were referred for treatment with chemotherapy, either SYS alone or a combination of SYS and HAI, according to the extent of disease and at the discretion of the treating medical oncologist. The indications for HAI chemotherapy in patients with ICC and the technique of HAI pump placement have been published previously . Briefly, patients were considered for HAI placement if they had liver‐confined disease with < 70% of the liver involved.…”

“…Exclusion criteria included prior hepatic radiation or treatment with FUDR, a Karnofsky performance status < 60, first‐degree sclerosing cholangitis, Gilbert's disease, portal hypertension, severe hepatic parenchymal dysfunction (encephalopathy, serum albumin < 2.5 g/dL, serum bilirubin ≥ 1.8 mg/dL, or international normalized ratio >1.5), portal inflow occlusion, a white blood cell count < 3500 cells/mm 3 , concurrent malignancy (except for localized basal or squamous cell skin cancers), active infection, and concurrent pregnancy or lactation (females). Forty‐four patients who received HAI were part of 2 previously reported clinical trials . The first trial reported 34 unresectable patients with primary liver cancer (26 with ICC) and investigated the use of dynamic contrast‐enhanced magnetic resonance imaging for the assessment of tumor vascularity as a biomarker of outcome.…”

“…In the face of disease progression in the liver, select patients received sideport injections of mitomycin C or gemcitabine. The administration of HAI and SYS chemotherapy has been described in several prior publications . A variety of systemic regimens were used in combination with HAI.…”

Multimodality treatment of intrahepatic cholangiocarcinoma: A review

“…Along with increased median OS, systemic toxicity has been shown to be reduced when using IAT. In a study with early termination involving systemic bevacizumab, six patients in the systemic group had doubling of their alkaline phosphatase, while no patients reported this finding in the HAI floxuridine group alone .…”

Hepatic Artery Infusion Chemotherapy for Liver Malignancy

“…In this trial, excessive biliary toxicity was observed in patients treated with BEV; 5 of 22 (23%) developed toxicity, 3 (14%) of whom required stent placement, compared with 2 of 34 (6%) with biliary toxicity without BEV and no stent placement. 82 Based on these findings, BEV was removed from the trial for safety reasons. Recently an update of these trials was published, focusing on those patients with ICC.…”