Adjuvant Therapy

Intera 3000 for patients with resected Colorectal Liver Metastases (CLM) (adjuvant therapy):

Treatment with the Intera 3000 and floxuridine combined with systemic chemotherapy can increase overall survival when provided as adjuvant therapy for patients with CLM who undergo liver resection compared to systemic chemotherapy alone.

According to a retrospective study of 2,368 consecutively treated patients at Memorial Sloan Kettering who underwent resection for CLM, patients who received an Intera 3000 pump with floxuridine and systemic chemotherapy had a median overall survival that was 20 months longer than patients treated with systemic chemotherapy alone. 10-year survival was 38% for the HAI therapy group compared to 23.8% for the systemic only group.

Adjuvant Therapy

A study of 2,368 patients who underwent complete resection of CLM who were consecutively enrolled in a prospectively maintained database showed that:

  • Patients who received the Intera 3000 plus systemic chemotherapy when compared to those patients who received systemic chemotherapy alone had a median overall survival 20 months greater (67 vs 47, p<0.001).
    • In propensity score analysis, the same strong association with overall survival was found with an adjusted hazard ration for HAI of 0.67 (P < 0.001)
  • Patients who received the Intera 3000 plus systemic chemotherapy had overall survival at 5 years of 52.9% versus 37.9% (P<0.001) and at 10 years of 38.0% versus 23.8% for systemic chemotherapy only (P<0.001).
  • Use of the Intera 3000 was not associated with increased overall survival in patients with extrahepatic disease, a positive resection margin, or a clinical risk score of 4 or 5. overall survival for patients in this study who did not receive the Intera 3000 was similar to overall survival in other large studies without the Intera 3000.
  • Limitations: this study was not a randomized, controlled trial therefore unmeasured prognostic factors could be unbalanced across treatment groups and partly explain the difference in overall survival . The study covers a period of 21 years including the introduction of irinotecan, oxaliplatin, and targeted treatments.[1]
[1]  Koerkamp BG, Sadot E, Kemeny NE, et al : Perioperative Hepatic Arterial Infusion Pump Chemotherapy

Is Associated With Longer Survival After Resection of Colorectal Liver Metastases: A Propensity Score Analysis. J Clin Oncol 35. © 2017 by American Society of Clinical Oncology

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