High Dose Melphalan Treatment for Liver Cancer
Author Information
Author(s): Vahrmeijer A L, van Dierendonck J H, Keizer H J, Beijnen J H, Tollenaar R A E M, Pijl M E J, Marinelli A, Kuppen P J K, van Bockel J H, Mulder G J, Velde C J H van de
Primary Institution: Leiden University Medical Center
Hypothesis
Isolated hepatic perfusion with melphalan allows for higher drug concentrations in the liver compared to systemic administration.
Conclusion
Isolated hepatic perfusion with melphalan can achieve significantly higher drug concentrations in the liver, but the treatment is complex and not suitable for routine clinical practice.
Supporting Evidence
- The peak L-PAM concentration and AUC of L-PAM in perfusate at dose level 3.0 mg kg−1 were significantly higher than in the systemic circulation.
- Median survival after IHP was 19 months.
- The overall response rate was 29% with one complete and four partial remissions.
Takeaway
Doctors tested a special way to give medicine to liver cancer patients that makes the medicine stronger in the liver, but it can be complicated and risky.
Methodology
A phase I dose-escalation study was conducted with 24 patients receiving escalating doses of melphalan via isolated hepatic perfusion.
Limitations
The treatment is complex and has significant risks, including severe side effects and complications.
Participant Demographics
Patients with colorectal cancer confined to the liver.
Statistical Information
P-Value
P≤0.001
Statistical Significance
p≤0.001
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website