BMC Cancer (Jul 2023)

Hepatic arterial infusion in combination with systemic chemotherapy in patients with hepatic metastasis from colorectal cancer: a randomized phase II study – (NCT05103020) – study protocol

  • Ji Su Kim,
  • Hyunwook Kim,
  • Seo Young Lee,
  • Yoon Dae Han,
  • Kichang Han,
  • Byung Soh Min,
  • Man-Deuk Kim,
  • Jong Yun Won,
  • Seung-Hoon Beom,
  • Sang Joon Shin,
  • Han Sang Kim,
  • Dai Hoon Han,
  • Joong Bae Ahn

DOI
https://doi.org/10.1186/s12885-023-11085-w
Journal volume & issue
Vol. 23, no. 1
pp. 1 – 7

Abstract

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Abstract Background Although 80% of patients with metastatic colorectal cancer (CRC) experience liver metastases, only 10–25% undergo resection at the time of diagnosis. Even in initially unresectable conditions, if appropriate treatment is provided, such as surgical conversion through a combination of hepatic arterial infusion (HAI) chemotherapy and systemic chemotherapy (sys-CT), better overall survival can be expected. Therefore, this study aims to evaluate the efficacy of HAI oxaliplatin in combination with sys-CT plus targeted therapy in patients with unresectable CRC with liver-only metastasis. Methods This is a single-center, randomized, open-label phase II trial (NCT05103020). Patients with untreated CRC, who have liver-only metastases and for whom liver resection is potentially possible but deemed infeasible at the time of initial diagnosis by a multidisciplinary team, will be eligible. Patients will be randomly assigned in a 1:1 ratio to either the combined HAI oxaliplatin and modified systemic 5-fluorouracil, folinic acid, and irinotecan (FOLFIRI) plus targeted therapy group or the systemic FOLFIRI plus targeted therapy group. Both regimens will be repeated every 2 weeks for a total of 12 cycles. The primary objective of this study is to compare the rate of conversion to liver resection. The surgical conversion rate is expected to increase by 25% with HAI oxaliplatin in combination with sys-CT plus targeted therapy (40% in the experimental arm versus 15% in the control arm) (power, 80%; two-sided alpha-risk, 5%). The secondary objectives include overall survival, progression-free survival, and objective response rate. Discussion This is the first randomized controlled trial to investigate the efficacy of HAI oxaliplatin in combination with sys-CT plus targeted therapy as first-line treatment from the initial diagnosis in patients with unresectable CRC with liver-only metastasis, aiming to significantly increase the surgical conversion rate. Trial registration ClinicalTrials.gov, (NCT05103020). Trial registration date: November 2, 2021.

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