15P - Transarterial chemoembolization with doxorubicin-loaded drug-eluting beads (DEBDOX) in the treatment of breast cancer liver metastases: A pilot study

Date 07 May 2015
Event IMPAKT 2015
Session Welcome reception and Poster Walk
Topics Anti-Cancer Agents & Biologic Therapy
Breast Cancer, Metastatic
Presenter Gema Bruixola
Citation Annals of Oncology (2015) 26 (suppl_3): 6-9. 10.1093/annonc/mdv115
Authors G. Bruixola1, R. García2, F. Gomez2, C. Escoín3, L. Palomar3, H. de la Cueva3, J.J. Martínez2, A. Santaballa3
  • 1Medical Oncology, Hospital Universitari i Politècnic La Fe, 46026 - Valencia/ES
  • 2Interventional Radiology, Hospital Universitari i Politècnic La Fe, Valencia/ES
  • 3Medical Oncology, Hospital Universitari i Politècnic La Fe, Valencia/ES

Abstract

Body

Introduction: Liver metastases of breast cancer confer a poor prognosis. Systemic chemotherapy remains the mainstay of treatment, but surgical resection could play a role in the management of oligometastatic disease. Since most patients are non-elective for surgery, new strategies involving a multimodality approach are required. Treatment with drug-eluting beads loaded with doxorubicin (DEBDOX) has proved to be safe and effective in hepatocellular carcinoma. We performed a study to assess feasibility of DEBDOX in breast cancer liver metastases.

Methods: We reviewed clinical records of breast cancer patients with unresectable liver metastases treated with DEBDOX between December 1st 2011 and January 30th 2014. Response rates, acute and late toxicities (late toxicity: registered 30 days after procedure), progression free survival (PFS), and overall survival (OS) were assessed.

Results: 7 DEBDOX were performed in 6 patients. Median age was 48 years (39-56). Liver metastases were metachronous in 5 patients and synchronous in 1. DEBDOX was used as 1st line in 4 patients and as 4th line in 2 patients. The mean dose of DEBDOX delivered was 158mg (range 100-300). All patients received systemic chemotherapy concurrent to DEBDOX. The most common acute toxicity was pain, grade 2 in 1 patient and grade 1 in 4 patients, with a mean Visual Analogue Score score of 2,33. No acute toxicities grade 3-4 were observed. Major late toxicities were grade 3 hypertransaminasemia in 1 patient and 1 cholecystitis. The overall response rate was 83,3%, with 2 complete responses (33,3%) and 3 partial responses (50%). After a median follow-up of 17,4 months (range 6,2-14,9), median PFS was 4,3 (CI 95% 0-9,5). 2 patients presented hepatic progression and 1 patient hepatic and extrahepatic progression (lung metastases). Median OS has not been reached yet (only 1 death).

Conclusions: According to our data, transarterial chemoembolization with DEBDOX presents an acceptable toxicity profile and promising efficacy for the treatment of unresectable liver metastases of breast cancer. Further studies are required to determine the optimal timing and systemic chemotherapy combination.

Disclosure: All authors have declared no conflicts of interest.