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Doxorubicin-Loaded 70–150 μm Microspheres for Liver-Dominant Metastatic Breast Cancer: Results and Outcomes of a Pilot Study

  • Clinical Investigation
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Abstract

Purpose

Patients with breast cancer liver metastasis have a poor prognosis. Local therapy for liver metastasis increases survival. The purpose of this pilot prospective study was to evaluate the efficacy and safety of doxorubicin drug-eluting beads chemoembolization for liver-dominant breast cancer metastasis (LdBM) refractory to chemotherapy.

Materials and Methods

All patients with LdBM refractory to of two or more lines of systemic chemotherapy were screened. Two chemoembolizations at 1-month intervals were scheduled for each patient. Tumor responses were evaluated by MRI every 3 months until progression or death. Adverse events were recorded according to the Common Terminology Criteria for Adverse Events (CTCAE version 4.02) 1 month after each chemoembolization. All patients were free from systemic treatment until progression. Patients with hormone-positive receptors and/or HER-positive disease status continued their targeted therapy.

Results

Out of 23 patients enrolled (mean age: 57.5 ± 11.5 years), 17 completed two chemoembolizations and six underwent only one because of severe adverse events. At 3-month follow-up, the disease control rate was 83 %. The median progression-free survival from the first chemoembolization was 8 months, and the median overall survival was 17 months. Nineteen patients remained free from any systemic chemotherapy for a mean of 209 ± 92 days until progression. Eight grade 3 (asthenia n = 3, anemia n = 2, thrombocythemia n = 2, liver toxicity n = 1) (Rev 1 Comment 1) occurred after the first procedure. No patient died directly due to the procedure.

Conclusion

While chemoembolization with doxorubicin eluding beads for refractory LdBM leads to an 83 % disease control rate, it also causes severe side effects that need to be adequately managed.

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Author notes

    Authors and Affiliations

    1. Interventional Radiology Department, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, 20, rue Leblanc, 75015, Paris, France

      Yen-Ting Lin, Grégory Amouyal, Carole Déan, Marc Sapoval & Olivier Pellerin

    2. Oncology Department, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, 20, rue Leblanc, 75015, Paris, France

      Jacques Médioni

    3. Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France

      Jacques Médioni, Grégory Amouyal, Marc Sapoval & Olivier Pellerin

    4. INSERM U970, Paris, France

      Marc Sapoval & Olivier Pellerin

    Authors
    1. Yen-Ting Lin
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    Correspondence to Olivier Pellerin.

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    None of the above authors have any conflict of interest or financial disclosures to declare.

    Consent and Ethics Statements

    This was a single-institution pilot study compliant with HIPAA and approved by the ethics committee. All patients provided their written informed consent.

    Additional information

    Yen-Ting Lin, Jacques Médioni, Grégory Amouyal, Carole Déan, and Marc Sapoval have contributed equally to this work.

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    Lin, YT., Médioni, J., Amouyal, G. et al. Doxorubicin-Loaded 70–150 μm Microspheres for Liver-Dominant Metastatic Breast Cancer: Results and Outcomes of a Pilot Study. Cardiovasc Intervent Radiol 40, 81–89 (2017). https://doi.org/10.1007/s00270-016-1465-4

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    • DOI: https://doi.org/10.1007/s00270-016-1465-4

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