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Hepatic arterial therapy with oxaliplatin and systemic capecitabine for patients with liver metastases from breast cancer

Lindgaard, S. C. ; Brinch, C. M. ; Jensen, B. K. ; Nørgaard, H. H. ; Hermann, K. L. ; Theile, S. ; Larsen, F. O. ; Jensen, B. V. ; Michelsen, H. and Nelausen, K. M. , et al. (2019) In Breast 43. p.113-119
Abstract

Objectives: Hepatic arterial treatment (HAT) for liver metastases in patients with metastatic breast cancer (MBC) has only been investigated in few studies. Materials and methods: Two phase II trials were initiated simultaneously to evaluate capecitabine in combination with oxaliplatin in patients with MBC and liver metastases. These two trials are reported together. Continuous capecitabine (1300 mg/m2) was combined with oxaliplatin (85 mg/m2) alternating between systemic treatment and HAT followed by degradable starch microspheres with EmboCept® S every second week. Four patients participated in a pharmacokinetic analysis of oxaliplatin. Each patient had samples taken when receiving oxaliplatin systemically and as HAT with... (More)

Objectives: Hepatic arterial treatment (HAT) for liver metastases in patients with metastatic breast cancer (MBC) has only been investigated in few studies. Materials and methods: Two phase II trials were initiated simultaneously to evaluate capecitabine in combination with oxaliplatin in patients with MBC and liver metastases. These two trials are reported together. Continuous capecitabine (1300 mg/m2) was combined with oxaliplatin (85 mg/m2) alternating between systemic treatment and HAT followed by degradable starch microspheres with EmboCept® S every second week. Four patients participated in a pharmacokinetic analysis of oxaliplatin. Each patient had samples taken when receiving oxaliplatin systemically and as HAT with and without EmboCept® S. Results: Totally, 52 patients received HAT: 14 with liver metastases only and 38 patients with additional limited metastatic disease. The patients had previously received a median of 2 (range 0–6) chemotherapeutic regimens for MBC. The response rate was 42.3% (95% confidence interval (CI) 28.7–56.8%) with 7.7% complete and 34.6% partial responses. Median progression free survival was 10.8 months (95% CI 6.9–14.7 months) and median overall survival 27.6 months (95% CI 20.4–34.8 months). The toxicity was moderate with hand-foot syndrome (15.4%), neuropathy (9.6%), fatigue (9.6%), and abdominal pain (9.6%) being the most common grade 3 adverse events. There was no clear difference between systemic blood concentrations of oxaliplatin when given systemic or as HAT. Conclusion: HAT oxaliplatin in combination with capecitabine is safe and efficient in patients with MBC. The results are promising with high response rates and a long median progression free and overall survival.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Breast neoplasms, Capecitabine, Chemoembolization, Oxaliplatin, Phase II
in
Breast
volume
43
pages
7 pages
publisher
Churchill Livingstone
external identifiers
  • pmid:30544058
  • scopus:85059338900
ISSN
0960-9776
DOI
10.1016/j.breast.2018.12.002
language
English
LU publication?
yes
id
73456083-6f40-4c9f-a4b8-4be9081c07c9
date added to LUP
2019-01-11 08:27:28
date last changed
2020-10-20 02:02:32
@article{73456083-6f40-4c9f-a4b8-4be9081c07c9,
  abstract     = {<p>Objectives: Hepatic arterial treatment (HAT) for liver metastases in patients with metastatic breast cancer (MBC) has only been investigated in few studies. Materials and methods: Two phase II trials were initiated simultaneously to evaluate capecitabine in combination with oxaliplatin in patients with MBC and liver metastases. These two trials are reported together. Continuous capecitabine (1300 mg/m2) was combined with oxaliplatin (85 mg/m2) alternating between systemic treatment and HAT followed by degradable starch microspheres with EmboCept<sup>®</sup> S every second week. Four patients participated in a pharmacokinetic analysis of oxaliplatin. Each patient had samples taken when receiving oxaliplatin systemically and as HAT with and without EmboCept<sup>®</sup> S. Results: Totally, 52 patients received HAT: 14 with liver metastases only and 38 patients with additional limited metastatic disease. The patients had previously received a median of 2 (range 0–6) chemotherapeutic regimens for MBC. The response rate was 42.3% (95% confidence interval (CI) 28.7–56.8%) with 7.7% complete and 34.6% partial responses. Median progression free survival was 10.8 months (95% CI 6.9–14.7 months) and median overall survival 27.6 months (95% CI 20.4–34.8 months). The toxicity was moderate with hand-foot syndrome (15.4%), neuropathy (9.6%), fatigue (9.6%), and abdominal pain (9.6%) being the most common grade 3 adverse events. There was no clear difference between systemic blood concentrations of oxaliplatin when given systemic or as HAT. Conclusion: HAT oxaliplatin in combination with capecitabine is safe and efficient in patients with MBC. The results are promising with high response rates and a long median progression free and overall survival.</p>},
  author       = {Lindgaard, S. C. and Brinch, C. M. and Jensen, B. K. and Nørgaard, H. H. and Hermann, K. L. and Theile, S. and Larsen, F. O. and Jensen, B. V. and Michelsen, H. and Nelausen, K. M. and Holm, V. H. and Ekblad, L. and Soerensen, Peter G. and Nielsen, D. L.},
  issn         = {0960-9776},
  language     = {eng},
  pages        = {113--119},
  publisher    = {Churchill Livingstone},
  series       = {Breast},
  title        = {Hepatic arterial therapy with oxaliplatin and systemic capecitabine for patients with liver metastases from breast cancer},
  url          = {http://dx.doi.org/10.1016/j.breast.2018.12.002},
  doi          = {10.1016/j.breast.2018.12.002},
  volume       = {43},
  year         = {2019},
}