Liver metastasis is recognized as a risk factor for metastatic breast cancer (MBC). Hepatic arterial infusion chemotherapy (HAIC) is a treatment option for MBC in patients with extensive hepatic lesions; however, there is no standard regimen, and the effects have not been well discussed.
We reviewed our medical records of MBC to extract patients with resistance to standard systemic chemotherapies, critical liver metastasis, and who received HAIC with an FEM regimen (5-fluorouracil 333 mg/m2 [weekly], epirubicin 30 mg/m2 [every 4 weeks], and mitomycin-C 2.7mg/m2 [every 2 weeks]) in our institute.
We identified 58 patients who received HAIC (median age at initiation, 58 [30-80] years) in our institute between 2002 and 2017. Their ECOG performance (PS) statuses were as follows: PS0, 44; PS1, 10; and PS 2, 4. Their receptor statuses were as follows: hormone receptor positive (HR+)/HER2+, 9; HR+/HER2-, 38; HR-/HER2+, 4; HR-/HER2-, 7. The median number of systemic regimens (including endocrine therapy) prior to HAIC was 6 (2-17). The median number of liver metastases was 8 (1-≥20); the median maximum size of liver metastases was 5.2 cm (1.6-20.1). The median number of extrahepatic metastatic site was 2 (0-5). The median overall survival (days) was as follows: overall, 371 (95% confidence interval [CI] 260-475); HER2+, 441 (95% CI 166-652); HER2-, 344 (95% CI 279-475). The median time to progression of intrahepatic lesions (days) was as follows: overall, 303 (95% CI 184-491); HER2+, 491 (95% CI 90-NR); HER2-, 298 (95% CI 184-387). An objective response (CR+PR) of intrahepatic lesions was observed in 37 patients (63.8%). The reasons for the discontinuation of HAIC included: progression of extrahepatic lesion(s), 20 (34.5%); progression of intrahepatic legion(s), 16 (27.6%); clinical progression, 7 (12.1%); transition to maintenance therapy, 6 (10.3%); catheter-related events, 5 (8.6%); and duodenal ulcer, 1 (1.7%).
HAIC with an FEM regimen offers an effective treatment for patients with liver metastasis from MBC that shows resistance to systemic therapy.
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All authors have declared no conflicts of interest.