The Use of Hepatic Artery Infusion for Colorectal Cancer With Liver Metastases

Jashodeep Datta, MD, Sylvester Comprehensive Cancer Center at University of Miami, Miller School of Medicine, Florida, discusses the use of hepatic artery infusion pumps to administer chemotherapy for colorectal cancer that has metastasized to the liver.

Dr Datta explains his view on the place of HAI in this treatment landscape, and how this procedure compares to transarterial radioembolization with Yttrium-90 (Y90).

Transcript:

My name is Jash Datta, I am a hepatobiliary and pancreatic surgical oncologist at the University of Miami and Sylvester Comprehensive Cancer Center.

I do believe that HAI is going to become more mainstream. For the longest time hepatic artery infusion was performed really at one beacon institution, ivory tower Institution, around the country, which was Sloan Kettering. But, for example, I trained there, and I brought that expertise to South Florida, to the University of Miami. And many trainees from Sloan Kettering have done that, and they have trained people who have now gone and started programs.

As the paradigm of hepatic artery infusion becomes more widespread, I do believe that it will find a firmer ground and have more applications for patients and really become more accessibility for patients with unresectable and even resectable colorectal liver metastases.

I do believe that at this moment HAI is superior to bilobar Y90 in the context of patients who have unresectable multifocal bilobar disease. Really, it's about the fact that we have to leverage chemotherapy that has already worked in these patients with 5-FU–based treatments, and we can deliver massive amounts of those treatments that don't have the systemic toxicity. We can consolidate those treatments in the liver for these patients. And I do believe that it is very safe to do in patients at particularly centers that have a high level of expertise, such as ours.

In the long run, I do believe there is benefit, in terms of toxicity as well as cost when you compare to Y90 or other liver-directed approaches. Particularly if you're trying to get toward curative intent. It's really not a one size fits all, and that's really what I want to communicate. In the right patient, in the right setting with the right biology, I do believe that HAI is a superior therapy.