AUTHOR=Randrian Violaine , Pernot Simon , Sionneau Baptiste , Smith Denis , Lim Annie , Touchefeu Yann , Gallois Claire , Turpin Anthony , Javed Sahir , Guimbaud Rosine , Rivera Pascale , Karoui Mehdi , Auclin Edouard , Taieb Julien 

TITLE=Hepatic Arterial Infusion Chemotherapy With Folfirinox or Oxaliplatin Alone in Metastatic Colorectal Cancer

JOURNAL=Frontiers in Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.830595

DOI=10.3389/fmed.2022.830595

ISSN=2296-858X

ABSTRACT=<sec><title>Background</title><p>Hepatic arterial infusion (HAI) of chemotherapy is an option for the treatment of patients with liver metastases from colorectal cancer (LMCRC). Though HAI with oxaliplatin (HAI-Ox) is generally used, intravenous (IV) 5-fluoro-uracil (5FU)-oxaliplatin-irinotecan HAI (HAI-Folfirinox) is feasible and leads to curative-intent surgery in 30% of pretreated patients. We compared the efficacy and safety of HAI-Ox and HAI-Folfirinox.</p></sec><sec><title>Methods</title><p>Patients who underwent HAI chemotherapy for LMCRC were retrospectively included from 2008 to 2019 from six French expert centers.</p></sec><sec><title>Results</title><p>Data were collected from 273 previously treated patients with LMCRC. Patients received HAI-Folfirinox (<italic>n</italic> = 52) or HAI-Ox (<italic>n</italic> = 221) combined with IV chemotherapy. The objective response rate (ORR) was 43.2% in patients with HAI-Folfirinox and 45.9% (ns) in patients with HAI-Ox. Median overall survival (OS) was 17 months (95% CI: 15–32.3) with HAI-Folfirinox and 26.2 months (95% CI: 19.4–34.4; <italic>p</italic> = 0.1) with HAI-Ox. Median progression-free survival (PFS) was 7.9 months (95% CI: 4.9–10.3) with HAI-Folfirinox and 6.4 months (95% CI: 6.0–7.7; <italic>p</italic> = 0.6) with HAI-Ox. The secondary liver resection rate was 35.6% with HAI-Folfirinox and 16.7% with HAI-Ox (<italic>p</italic> = 0.007). Grade 2 and above toxicities were significantly more frequent with HAI-Folfirinox. In the global population, only 2 factors were prognostic for OS in multivariable analyses: liver-only disease [hazard ratio (HR): 0.4; 95% CI 0.20–0.83; <italic>p</italic> = 0.013] and local complications of the catheter (HR: 3.8; 95% CI 1.6–9.0; <italic>p</italic> = 0.002).</p></sec><sec><title>Conclusion</title><p>Hepatic arterial infusion results in high response rates, secondary resections, and long survival in pretreated patients with LMCRC.</p></sec>