Abstract 70P
Background
Oxaliplatin based hepatic arterial infusions (HAI) are very promising for colorectal cancer with liver-only metastasis. The three main indications are in the neoadjuvant setting, the adjuvant setting, or in the palliative setting. Our study aimed to compare the response rates and the toxicity profiles between two groups of patients, those who were oxaliplatin-naïve and were receiving the molecule for the first time as an intra-arterial infusion, and those who had received systemic oxaliplatin in previous lines.
Methods
Between 2008 and 2022, single-center consecutive patients presenting with liver metastasis secondary to colorectal cancer who received at least one cycle of HAI-oxaliplatin, either as an intensification or in the palliative setting, were analyzed.
Results
The control arm (oxaliplatin-naïve) included a total of 63 patients; and the second arm (pre-treated) included a total of 244 patients. Patient characteristics were well balanced between the two groups. All patients in the control arm received HAI-oxaliplatin while 13% of the pre-treated patients received the OPTILIV regimen instead. Patients had previously received a median of 0.6 lines in the oxaliplatin-naïve group and 2.3 lines in the pre-treated group. After a median follow up of 30 months, median progression free survival was 14 months in the control group and 10.1 months in the pre-treated group (p-value 0.0016). An ORR of 66.7% and a disease control rate of 79.4% were observed in the former, and an ORR of 32.4% and a disease control rate of 77.5% were observed in the latter (p-value <0.001). Secondary resection or ablation was achieved in 22.2% and 17.6% respectively. Grade 3/4 toxicities were comparable between the two groups, particularly in regard to peripheral sensory neuropathy (17% versus 13%).
Conclusions
Oxaliplatin rechallenge as an intra-arterial hepatic infusion is feasible and efficient after previous systemic oxaliplatin, as it showed significant response rates without an increase in observed toxicities. Thus, oxaliplatin rechallenge using HAIC route can provide alternative treatments and spare late setting drugs such as Regorafenib and Tipiracil-trifludirine for a more palliative intent treatment.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.