Chemosaturation Percutaneous Hepatic Perfusion: A Systematic Review

Area of Science:

• Oncology
• Medical Devices
• Interventional Radiology

Background:

• Unresectable primary liver tumors and hepatic metastases pose significant treatment challenges.
• Current treatment options often have limitations in efficacy and systemic toxicity.
• Locoregional therapies are being explored to improve outcomes for liver malignancies.

Purpose of the Study:

• To evaluate the efficacy and safety of the Hepatic CHEMOSAT® Delivery System for chemosaturation percutaneous hepatic perfusion (CS-PHP).
• To assess CS-PHP with melphalan in patients with unresectable liver tumors, including primary liver cancer and metastatic disease.
• To analyze tumor response rates and safety profiles across various liver tumor histologies.

Main Methods:

• Utilized the Hepatic CHEMOSAT® Delivery System to perform CS-PHP.
• Administered high-dose melphalan directly to the liver, limiting systemic exposure.
• Conducted clinical trials and analyzed published studies and case reports for efficacy and safety data.

Main Results:

• CS-PHP with melphalan significantly improved hepatic progression-free survival in patients with unresectable hepatic metastases from melanoma.
• Clinically meaningful hepatic responses were observed in patients with hepatocellular carcinoma and neuroendocrine tumors.
• Favorable tumor response rates were noted across various histologies, including melanoma, colorectal cancer, and hepatobiliary tumors.

Conclusions:

• CS-PHP with melphalan is a promising locoregional therapy for primary and secondary liver tumors.
• The procedure demonstrates a clinically acceptable safety profile with manageable adverse events, primarily hematologic.
• This innovative delivery system offers a potential new treatment avenue for patients with unresectable liver malignancies.