Hope for People with Liver Cancer

A study at St. Joseph's Hospital and Medical Center in Tampa, Fla., Included 25 patients who had colorectal cancer that had spread to the liver and 11 with primary liver cancer. All of the patients with primary liver cancer received LC Beads (TM) that emitted doxorubicin, a type of chemotherapeutic agent, while 13 of the colorectal patients received doxorubicin-emitting beads and 12 received beads that emitted irinotecan, another chemotherapeutic agent. The patients who received the doxorubicin-eluting beads fared better - 10 of 11 (91 percent) of the primary liver cancer patients and 10 of the 13 (77 percent) of the colorectal patients were alive after two years. Conversely, one of 12 (8.3 percent) of the irinotecan patients were alive after two years. Researchers are studying why doxorubicin appears to work better in these cases.

LC Beads slowly elute the chemotherapuetic agent over the course of two weeks, providing a constant dose of the drug to the tumor, without leading to systemic side effects.

"There is definitely a chance of cancer cure with this procedure beyond just palliation," said Glenn Stambo, MD, vascular and interventional radiologist at St. Joseph's Hospital and Medical Center. "The more isolated the tumor and its blood vessel feeders, the better the chance for a complete cure."

Improvements in Chemoembolization

A multicenter Italian trial used HepaSphere (TM) beads loaded with chemotherapeutic agents to deliver treatment to 53 patients with liver cancer. HepaSpheres are designed to expand after they lodge in the arteries that feed the tumor, so that blood flow is more effectively blocked; these microspheres absorb the chemotherapeutic agent, and then the drug is released directly into the tumor.

A month after treatment, tumors in 27 of the patients (51 percent) showed a complete response, 18 (34 percent) showed a partial response and eight (15 percent) showed stable disease. Six months later 19 of 34 patients (55.9 percent) had complete tumor response, eight (23.5 percent) had a partial response and seven (20.5 percent) had growing disease. Of the remaining 19 patients, three died, four were lost at follow-up and 12 receive other treatments.

"Patients who still had good liver function and who had tumors in only one lobe of the liver did better with this treatment," said Maurizio Grosso, MD, chairman of the Department of Radiology at Santa Croce & Carle Hospital, Cuneo, Italy. "We're hopeful that treatment with HepaSphere will be an improvement over traditional chemoembolization."

Embolization without Chemotherapy

Researchers at the European Institute of Oncology in Milan, Italy, are studying using embolization without the chemotherapy for liver cancer. The study included 25 patients with 34 primary liver tumors. All patients received Embozene (TM) microspheres alone, without the addition of any chemotherapeutic agents in the beads. The patients had 35 sessions with the microspheres. After one month follow-up, 18 tumors (52 percent) had shrunk in size while 16 (48 percent) were the same size with no tumor growth detected. In a group of 16 tumors with a follow up ranging between six and 12 months, two tumors (12 percent) completely disappeared, seven tumors (44 percent) continued to shrink, two (12 percent) were stable and five (31 percent) grew , although they were still of a size suitable for new local treatments. To date, 14 patients have had more than one year of follow-up care and 93 percent of them are still alive.

"One concern with embolization is that blocking the tumor feeding vessels in some cases leads to restriction in blood flow and cell death," said Franco Orsi, MD, chief of interventional radiology at the European Institute of Oncology. "One of the main benefits of Embozene microspheres is the precise, well-calibrated sizing, which match the small blood vessels that feed the tumors. The larger the particles used, the further away the embolization from the tumor and the less effective the treatment will be. Moreover, embolization without drugs usually causes few or no post-treatment side effects and patient can usually be discharged the next day. "

Considered to be the premier meeting on endovascular therapy, the International Symposium on Endovascular Therapy (ISET) is attended by more than 1,200 physicians, scientists, allied health professionals and industry professionals from around the world.