A New Option for the Treatment of Intrahepatic Cholangiocarcinoma: Percutaneous Hepatic Perfusion with CHEMOSAT Delivery System

Liver metastases are a major management problem; since they occur in tumors of different origin, they are often multiple, difficult to visualize and can lie dormant for many years. Patients with liver metastases usually die of their disease, mostly due to liver failure, since systemic treatments are...

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Main Authors: Pier Francesco Ferrucci, Emilia Cocorocchio, Guido Bonomo, Gianluca Maria Varano, Paolo Della Vigna, Franco Orsi
Format: Article
Language:English
Published: MDPI AG 2021-01-01
Series:Cells
Subjects:
Online Access:https://www.mdpi.com/2073-4409/10/1/70
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author Pier Francesco Ferrucci
Emilia Cocorocchio
Guido Bonomo
Gianluca Maria Varano
Paolo Della Vigna
Franco Orsi
author_facet Pier Francesco Ferrucci
Emilia Cocorocchio
Guido Bonomo
Gianluca Maria Varano
Paolo Della Vigna
Franco Orsi
author_sort Pier Francesco Ferrucci
collection DOAJ
description Liver metastases are a major management problem; since they occur in tumors of different origin, they are often multiple, difficult to visualize and can lie dormant for many years. Patients with liver metastases usually die of their disease, mostly due to liver failure, since systemic treatments are unable to eradicate micro-metastasis, and interventional loco-regional procedures cannot treat all existing ones. Cholangiocarcinoma (CCA) is the second most common primary liver tumor, showing a poor overall prognosis. When resection is not possible, treatment options include tumor-focused or local ablative therapy, organ-focused or regional therapy and systemic therapy. We reviewed available loco-regional therapeutic options, with particular focus on the CHEMOSAT<sup>®</sup> Melphalan/Hepatic Delivery System (CS-HDS), which is uniquely positioned to perform a percutaneous hepatic perfusion (PHP), in order to treat the entire liver as a standalone or as complementary therapy. This system isolates the liver circulation, delivers a high concentration of chemotherapy (melphalan), filters most chemotherapy out of the blood and is a repeatable procedure. Most CS-HDS benefits are demonstrated in liver-predominant diseases, like liver metastasis from uveal melanoma (UM), hepatocarcinoma (HCC) and CCA. More than 650 procedures have been performed in Europe to date, mostly to treat liver metastases from UM. In CCA, experience is still limited, but retrospective analyses have been reported, while phase II and III studies are closed, waiting for results or ongoing.
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spelling doaj.art-b8ae8d92952741088679d866bf836d152023-11-21T08:17:57ZengMDPI AGCells2073-44092021-01-011017010.3390/cells10010070A New Option for the Treatment of Intrahepatic Cholangiocarcinoma: Percutaneous Hepatic Perfusion with CHEMOSAT Delivery SystemPier Francesco Ferrucci0Emilia Cocorocchio1Guido Bonomo2Gianluca Maria Varano3Paolo Della Vigna4Franco Orsi5Tumor Biotherapy Unit, Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20141 Milan, ItalyHematoncology Division, European Institute of Oncology, IRCCS, 20141 Milan, ItalyInterventional Radiology Division, European Institute of Oncology, IRCCS, 20141 Milan, ItalyInterventional Radiology Division, European Institute of Oncology, IRCCS, 20141 Milan, ItalyInterventional Radiology Division, European Institute of Oncology, IRCCS, 20141 Milan, ItalyInterventional Radiology Division, European Institute of Oncology, IRCCS, 20141 Milan, ItalyLiver metastases are a major management problem; since they occur in tumors of different origin, they are often multiple, difficult to visualize and can lie dormant for many years. Patients with liver metastases usually die of their disease, mostly due to liver failure, since systemic treatments are unable to eradicate micro-metastasis, and interventional loco-regional procedures cannot treat all existing ones. Cholangiocarcinoma (CCA) is the second most common primary liver tumor, showing a poor overall prognosis. When resection is not possible, treatment options include tumor-focused or local ablative therapy, organ-focused or regional therapy and systemic therapy. We reviewed available loco-regional therapeutic options, with particular focus on the CHEMOSAT<sup>®</sup> Melphalan/Hepatic Delivery System (CS-HDS), which is uniquely positioned to perform a percutaneous hepatic perfusion (PHP), in order to treat the entire liver as a standalone or as complementary therapy. This system isolates the liver circulation, delivers a high concentration of chemotherapy (melphalan), filters most chemotherapy out of the blood and is a repeatable procedure. Most CS-HDS benefits are demonstrated in liver-predominant diseases, like liver metastasis from uveal melanoma (UM), hepatocarcinoma (HCC) and CCA. More than 650 procedures have been performed in Europe to date, mostly to treat liver metastases from UM. In CCA, experience is still limited, but retrospective analyses have been reported, while phase II and III studies are closed, waiting for results or ongoing.https://www.mdpi.com/2073-4409/10/1/70intrahepatic cholangiocarcinomaliver metastasisregional therapypercutaneous hepatic perfusion
spellingShingle Pier Francesco Ferrucci
Emilia Cocorocchio
Guido Bonomo
Gianluca Maria Varano
Paolo Della Vigna
Franco Orsi
A New Option for the Treatment of Intrahepatic Cholangiocarcinoma: Percutaneous Hepatic Perfusion with CHEMOSAT Delivery System
Cells
intrahepatic cholangiocarcinoma
liver metastasis
regional therapy
percutaneous hepatic perfusion
title A New Option for the Treatment of Intrahepatic Cholangiocarcinoma: Percutaneous Hepatic Perfusion with CHEMOSAT Delivery System
title_full A New Option for the Treatment of Intrahepatic Cholangiocarcinoma: Percutaneous Hepatic Perfusion with CHEMOSAT Delivery System
title_fullStr A New Option for the Treatment of Intrahepatic Cholangiocarcinoma: Percutaneous Hepatic Perfusion with CHEMOSAT Delivery System
title_full_unstemmed A New Option for the Treatment of Intrahepatic Cholangiocarcinoma: Percutaneous Hepatic Perfusion with CHEMOSAT Delivery System
title_short A New Option for the Treatment of Intrahepatic Cholangiocarcinoma: Percutaneous Hepatic Perfusion with CHEMOSAT Delivery System
title_sort new option for the treatment of intrahepatic cholangiocarcinoma percutaneous hepatic perfusion with chemosat delivery system
topic intrahepatic cholangiocarcinoma
liver metastasis
regional therapy
percutaneous hepatic perfusion
url https://www.mdpi.com/2073-4409/10/1/70
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