Hepatic Artery Infusion Pump Therapy for Intrahepatic Cholangiocarcinoma: Indications and Outcomes

Prognosis for patients with unresectable intrahepatic cholangiocarcinoma (iCC) remains poor despite advances in systemic therapy. This review delineates the indications and outcomes for hepatic artery infusion pump (HAIP) therapy in patients with liver-limited iCC based on retrospective reviews and single-arm studies. Early results have shown favorable outcomes when incorporating HAIP in the management strategy, including impressive 3-year survival rates ranging from 31 to 40%. Randomized controlled trials will be vital in defining the role of HAIP in current treatment regimens (e.g. first-line vs. second-line). As data continue to accumulate, we emphasize the importance of patient selection within the context of comprehensive multidisciplinary evaluation. Finally, we discuss promising new therapeutic strategies for HAIP as applied to patients with cholangiocarcinoma, including the introduction of novel agents, and approaches to mitigating dose-limiting toxicities, and thereby maximizing therapeutic benefit.