Join us for the Colorectal Cancer Community Conference on May 18th & 19th. Click here for complimentary registration.

Hepatic Artery Infusion pumps in patients with colorectal cancer with liver metastases

22 December 2020

Hepatic Artery Infusion (HAI) chemotherapy is sometimes used as adjuvant treatment (treatment that accompanies the primary treatment to increase its effectiveness) in combination with systemic chemotherapy for the treatment of colorectal liver metastases.
Hepatic Artery Infusion (HAI) involves the continuous infusion of chemotherapy drugs directly into the liver from a pump that is inserted just below the skin. A catheter leaves the pump and is surgically connected to a branch of the hepatic artery.
In colorectal cancer (CRC), the liver is the most common site of metastases. About 50% of patients with CRC develop liver metastases in the course of their disease, and surgical resection remains the only treatment that offers a chance of cure and long-term survival (Chow, 2019). Only a minority of patients, however, is eligible for upfront surgery. HAI can be used in combination with systemic chemotherapy in the following instances:

· Among most patients who have liver metastases that are considered inoperable, HAI can reduce tumour size and increase the likelihood of surgical removal of liver metastases – about a third of patients so treated will become eligible for surgery;

· Among patients with operable liver tumours, HAI can be used to reduce the chance of tumour recurrence.

A recent retrospective study showed that adjuvant HAI offered an increased overall survival, better response rates to treatment, and improved physical functioning compared to systemic chemotherapy alone (Kemeny, 2017).

The HAI pump takes advantage of the fact that liver metastases receive their blood supply from the artery that feeds the liver – the hepatic artery. While the liver receives blood flow from two different sources, one third from the hepatic artery and two thirds from the portal vein, CRC liver metastases receive blood exclusively from the hepatic artery.

Beginning in the 1970s, chemotherapy was directly infused into the liver via the hepatic artery, allowing for higher concentrations of chemotherapy to be administered directly to the liver without causing high levels of toxicity to the rest of the body. Ongoing studies continue to examine the survival outcomes of HAI and any additional benefits it may offer in comparison to systemic chemotherapy. Despite the dramatic responses that HAI can offer, it remains a highly specialized technique that requires unique expertise, limiting its use to specific centres only.

Take home message: Hepatic arterial infusion (HAI) is a treatment option for patients with colorectal cancer liver metastases that allows for a higher concentration of chemotherapy to be directly administered to the liver without causing high levels of toxicity to the rest of the body. HAI may be used to prevent tumour recurrence in the liver after surgery, or to help shrink liver metastases to increase the chances that they can be surgically removed.

Chow, F and Chok, K. Colorectal liver metastases: An update on multidisciplinary approach. World J Hepatol. 2019 Feb 27; 11(2): 150-172. Published online 2019 Feb 27. doi: 10.4254/wjh.v11.i2.150

Kemeny, N. et al. Updated long-term survival for patients with metastatic colorectal cancer treated with liver resection followed by hepatic arterial infusion and systemic chemotherapy. J Surg Oncol. Author manuscript; available 2017 Apr 1. doi: 10.1002/jso.24189

Addressing cancer disparities in Canada

April is Diversity Month dedicated to celebrating and honouring all in [...]

READ MORE

The role of maintenance strategies in metastatic colorectal cancer

Results from a systematic review published in JAMA Oncology found that [...]

READ MORE

Swallowable capsule camera for home endoscopy

The National Health Service (NHS) in England will be conducting a stud [...]

READ MORE

Liquid biopsy for colorectal cancer could guide therapy for tumours

A study published in the Journal of Clinical Oncology Precision Oncology s [...]

READ MORE

ASCO names molecular profiling of gastrointestinal cancer “Advance of the Year”

Molecular profiling in gastrointestinal (GI) cancer has been named by [...]

READ MORE

The Importance of Self-care for Caregivers

Your physical, emotional and mental well-being are vital to your ability t [...]

READ MORE

Rates of eligible people missing timely cancer screenings: A Canadian analysis

New findings from the University of Alberta published in the Journal of th [...]

READ MORE

Postsurgical disease recurrence in stage I to III colorectal cancer may be predicted by ctDNA

Findings from a recent study presented at the 2021 Gastrointestinal Ca [...]

READ MORE

Survey Results: Never Too Young

Colorectal cancer is the second most diagnosed cancer in Canada. Twent [...]

READ MORE

Statins reduced risk of colorectal cancer in meta-analysis

10 December 2020Findings from a recent study showed that people who regula [...]

READ MORE

“Test all patients with cancer”: 1 in 8 have inherited mutations

November 2020 Findings from a recent study conducted by the Mayo Clinic [...]

READ MORE

Rectal cancer management: do all patients need to undergo surgery?

The non-surgical management or  “watch-and-wait” approach for rectal c [...]

READ MORE

Palliative care for young adults is a growing reality in CRC

The incidence of colorectal cancer (CRC) is rising among young adults, who [...]

READ MORE

OPTIMISTICC Research Program sheds light on importance of gut microbiome in colorectal cancer development and treatment

Opportunity to Investigate the Microbiome’s Impact on Science and Treatmen [...]

READ MORE

Cancer Survivors Urgently Need Better Nutritional Support

New findings from a study conducted at the University of Sheffield in [...]

READ MORE

Intimacy and Colorectal Cancer

Sexuality and relationships during and after cancer is extremely impor [...]

READ MORE

Understanding early-onset colorectal cancer: why are cases on the rise?

Chadwick Boseman’s death from colorectal cancer (CRC) at age 43 was a shoc [...]

READ MORE

World Metastatic Colorectal Cancer Day

Today, Wednesday September 30th, is World Metastatic Colorectal Cancer Day [...]

READ MORE

Optimal sequencing strategies in metastatic colorectal cancer

Dr. Heinz-Josef Lenz, MD, discusses optimal sequencing strategies for [...]

READ MORE

ESMO Virtual Congress 2020: Colorectal cancer highlights

The European Society for Medical Oncology ESMO Virtual Congress 2020 t [...]

READ MORE

Welcoming Our Newest CCC Ambassador, Jesse Fishman!

Jesse Fishman is a 17-year-old hockey player, currently playing for the Ki [...]

READ MORE

Do young diabetes patients need early CRC screening?

12 August 2020 Recent findings from a Swedish cohort study found that p [...]

READ MORE

Cancer Recurrence amid COVID-19: Robin’s Story

It was the day of the lockdown. My family doctor called. “The colorectal c [...]

READ MORE

Never Too Young Survey Launch

Fill out the survey! The world was shocked late last week as we learned a [...]

READ MORE

Gut bacteria found to modulate response to cancer immunotherapy

Previous data have shown that certain species of intestinal bacteria not o [...]

READ MORE

Your Seasonal Guide to Cancer-Fighting Foods

As we transition into autumn, take a moment to appreciate the seasonal pro [...]

READ MORE

Psychosocial support for patients with cancer during COVID-19

The COVID-19 pandemic has presented countless new challenges in cancer car [...]

READ MORE

COVID-19 NEWSLETTER

The COVID-19 pandemic situation is constantly evolving. Canada is slowly r [...]

READ MORE

CRC with peritoneal metastases: CRS-HIPEC refinements

Results of several new studies provide important perspectives on the use o [...]

READ MORE

Four actionable targets for metastatic colorectal cancer

In the past two years, findings from important clinical trials are shaping [...]

READ MORE

Patient Group Pathway Model to Accessing Cancer Clinical Trials and RWE Conference

Hold the Date! On behalf of Colorectal Cancer Canada (CCC), you are cordi [...]

READ MORE

Lynch Syndrome, Explained

What is Lynch Syndrome? Lynch syndrome is a genetically inherited conditi [...]

READ MORE

COVID-19 PATIENT SURVEY REPORT

Coronavirus has taken the world by storm since the beginning of 2020, and [...]

READ MORE

PUSH FOR YOUR TUSH VIRTUAL EVENT 2020

To ensure the health and safety of our participants, volunteers, staff and [...]

READ MORE

Gastrointestinal Highlights from last month’s ASCO 2020 Meeting

The American Society of Clinical Oncology (ASCO) held its annual meeting a [...]

READ MORE

How is colorectal cancer care changing in the era of COVID-19?

In just a few months, coronavirus (COVID-19) has transformed our lives. De [...]

READ MORE

Meatless for CRC prevention

It has been known for millennia that what we eat can be powerful medicine [...]

READ MORE

Immunotherapy treatment proves to be superior to chemotherapy for a specific subset of patients with mCRC

The last few decades have seen important advances in colorectal cancer tre [...]

READ MORE

Push For Your Tush volunteers spread the word

Co-leads of Push For Your Tush Ottawa share their connection to the cause [...]

READ MORE

2,700 VISITORS PASS THROUGH GIANT COLON TOUR AT THE SHERBROOKE HALF MARATHON

The Centre de recherche of the Centre hospitalier universitaire de Sherbro [...]

READ MORE

Colorectal cancer screening in Ontario is changing to the FIT

On June 24, 2019, colorectal cancer screening in Ontario is changing to th [...]

READ MORE

Remembering the “Father of Heredity Cancer” Dr. Henry Lynch

Today we remember Dr. Henry Lynch, esteemed researcher and father of hered [...]

READ MORE

Kicking cancer’s ass on the golf course

On Tuesday, July 16, Colorectal Cancer Canada (CCC) held our third annual [...]

READ MORE

Increasing rates of colon & rectal cancers in young people

Researchers with the World Health Organization confirm increased rates of [...]

READ MORE

CCC attends Early Age Onset Colorectal Cancer Summit in New York City

Last Thursday and Friday, Morgan Kennedy, CCC’s Never Too Young Program Ma [...]

READ MORE

Publication: Clinically meaningful survival benefit in refractory mCRC

Colorectal Cancer Canada (CCC) is proud to announce the publication of the [...]

READ MORE

Giant Colon visits University of Montreal Hospital Centre

Today, the Giant Colon Tour stopped at the University of Montreal Hospital [...]

READ MORE

CCC’s PUSH FOR YOUR TUSH SPARKS PARTNERSHIP WITH THE TORONTO PROFESSIONAL FIRE FIGHTERS ASSOCIATION

Most people do not know that cancer is the number one cause of death among [...]

READ MORE

March is Colorectal Cancer Awareness Month

March is Colorectal Cancer Awareness Month! Colorectal cancer may touch yo [...]

READ MORE

Sponsors