Yen-Ting Lin1, Jacques Médioni2,3, Grégory Amouyal1,3, Carole Déan1, Marc Sapoval1,3,4, Olivier Pellerin5,6,7. 1. Interventional Radiology Department, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, 20, rue Leblanc, 75015, Paris, France. 2. Oncology Department, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, 20, rue Leblanc, 75015, Paris, France. 3. Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France. 4. INSERM U970, Paris, France. 5. Interventional Radiology Department, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, 20, rue Leblanc, 75015, Paris, France. olivier.pellerin@aphp.fr. 6. Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France. olivier.pellerin@aphp.fr. 7. INSERM U970, Paris, France. olivier.pellerin@aphp.fr.
Abstract
PURPOSE: Patients with breast cancer liver metastasis have a poor prognosis. Local therapy for liver metastasis increases survival. The purpose of this pilot prospective study was to evaluate the efficacy and safety of doxorubicin drug-eluting beads chemoembolization for liver-dominant breast cancer metastasis (LdBM) refractory to chemotherapy. MATERIALS AND METHODS: All patients with LdBM refractory to of two or more lines of systemic chemotherapy were screened. Two chemoembolizations at 1-month intervals were scheduled for each patient. Tumor responses were evaluated by MRI every 3 months until progression or death. Adverse events were recorded according to the Common Terminology Criteria for Adverse Events (CTCAE version 4.02) 1 month after each chemoembolization. All patients were free from systemic treatment until progression. Patients with hormone-positive receptors and/or HER-positive disease status continued their targeted therapy. RESULTS: Out of 23 patients enrolled (mean age: 57.5 ± 11.5 years), 17 completed two chemoembolizations and six underwent only one because of severe adverse events. At 3-month follow-up, the disease control rate was 83 %. The median progression-free survival from the first chemoembolization was 8 months, and the median overall survival was 17 months. Nineteen patients remained free from any systemic chemotherapy for a mean of 209 ± 92 days until progression. Eight grade 3 (asthenia n = 3, anemia n = 2, thrombocythemia n = 2, liver toxicity n = 1) (Rev 1 Comment 1) occurred after the first procedure. No patient died directly due to the procedure. CONCLUSION: While chemoembolization with doxorubicin eluding beads for refractory LdBM leads to an 83 % disease control rate, it also causes severe side effects that need to be adequately managed.
PURPOSE:Patients with breast cancer liver metastasis have a poor prognosis. Local therapy for liver metastasis increases survival. The purpose of this pilot prospective study was to evaluate the efficacy and safety of doxorubicin drug-eluting beads chemoembolization for liver-dominant breast cancer metastasis (LdBM) refractory to chemotherapy. MATERIALS AND METHODS: All patients with LdBM refractory to of two or more lines of systemic chemotherapy were screened. Two chemoembolizations at 1-month intervals were scheduled for each patient. Tumor responses were evaluated by MRI every 3 months until progression or death. Adverse events were recorded according to the Common Terminology Criteria for Adverse Events (CTCAE version 4.02) 1 month after each chemoembolization. All patients were free from systemic treatment until progression. Patients with hormone-positive receptors and/or HER-positive disease status continued their targeted therapy. RESULTS: Out of 23 patients enrolled (mean age: 57.5 ± 11.5 years), 17 completed two chemoembolizations and six underwent only one because of severe adverse events. At 3-month follow-up, the disease control rate was 83 %. The median progression-free survival from the first chemoembolization was 8 months, and the median overall survival was 17 months. Nineteen patients remained free from any systemic chemotherapy for a mean of 209 ± 92 days until progression. Eight grade 3 (asthenia n = 3, anemia n = 2, thrombocythemia n = 2, liver toxicity n = 1) (Rev 1 Comment 1) occurred after the first procedure. No patient died directly due to the procedure. CONCLUSION: While chemoembolization with doxorubicin eluding beads for refractory LdBM leads to an 83 % disease control rate, it also causes severe side effects that need to be adequately managed.
Entities:
Keywords:
Breast cancer; Chemoembolization; Disease-free survival; Drug eluted beads; Liver neoplasm; Survival rate
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