The Efficacy and Safety of Hepatic Arterial Infusion Chemotherapy for Mismatch Repair Proficient (pMMR)/Microsatellite Stable (MSS) Colorectal Cancer Liver Metastases (CRLM).
To assess the effectiveness and safety of hepatic arterial infusion chemotherapy (HAIC) in patients with mismatch repair proficient (pMMR)/microsatellite stable (MSS) colorectal cancer liver metastases (CRLM) who are resistant to standard treatments.
This study retrospectively evaluated 137 consecutive patients with pMMR/MSS CRLM who underwent HAIC from July 2019 to September 2023. Progression-free survival (PFS) was the primary outcome, with secondary outcomes being overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety. The Cox proportional hazards model was used to identify prognostic factors for survival.
In total, 78 patients participated, with a median age of 58 years (IQR, 50.75-64.00), and 50 were male. Among these, 28 were treated with a combination of HAIC and targeted therapy, whereas 50 were given HAIC monotherapy. For all patients, the median PFS and OS were 5.10 months (95% CI: 2.85, 7.35) and 16.80 months (95% CI: 13.07, 20.53), respectively. The ORR and DCR for intrahepatic lesions were 1.37% and 58.9%, respectively. All lesions had an ORR of 2.74% and a DCR of 30.14%. The 1-year OS rate was 67.63 (95% CI, 57.22, 79.91). Patients undergoing HAIC, whether with or without targeted therapy, showed no significant differences in ORR and DCR. Multivariable analysis showed that the combination of HAIC and targeted therapy was not an independent risk factor for PFS and OS. No adverse events of grade 4 or higher were observed.
HAIC shows effectiveness and tolerance in pMMR/MSS CRLM patients who are refractory to systemic therapy. However, the additive value of targeted therapy for HAIC in these patients needs to be further investigated.
This study retrospectively evaluated 137 consecutive patients with pMMR/MSS CRLM who underwent HAIC from July 2019 to September 2023. Progression-free survival (PFS) was the primary outcome, with secondary outcomes being overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety. The Cox proportional hazards model was used to identify prognostic factors for survival.
In total, 78 patients participated, with a median age of 58 years (IQR, 50.75-64.00), and 50 were male. Among these, 28 were treated with a combination of HAIC and targeted therapy, whereas 50 were given HAIC monotherapy. For all patients, the median PFS and OS were 5.10 months (95% CI: 2.85, 7.35) and 16.80 months (95% CI: 13.07, 20.53), respectively. The ORR and DCR for intrahepatic lesions were 1.37% and 58.9%, respectively. All lesions had an ORR of 2.74% and a DCR of 30.14%. The 1-year OS rate was 67.63 (95% CI, 57.22, 79.91). Patients undergoing HAIC, whether with or without targeted therapy, showed no significant differences in ORR and DCR. Multivariable analysis showed that the combination of HAIC and targeted therapy was not an independent risk factor for PFS and OS. No adverse events of grade 4 or higher were observed.
HAIC shows effectiveness and tolerance in pMMR/MSS CRLM patients who are refractory to systemic therapy. However, the additive value of targeted therapy for HAIC in these patients needs to be further investigated.