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High-dose FOLFIRI, surgery, and radiofrequency ablation for patients with unresectable liver metastases from colorectal cancer.

BACKGROUND
To evaluate a strategy combining high-dose 5FU-irinotecan-leucovorin (HD-FOLFIRI) chemotherapy, radiofrequency ablation and surgery in patients with unresectable liver metastases from colorectal cancer.


PATIENTS AND METHODS
Patients, all presenting UDP glucuronosyl transferase-1A1 (UGT1A1) 6/6 or 6/7 genotype, received HD-FOLFIRI (with high-dose irinotecan: 260 mg/m(2)), one cycle every two weeks. The feasibility of local therapy (surgery and/or radiofrequency) was assessed every four cycles. The objective of therapy was the complete clearance rate of metastases.


RESULTS
The trial was terminated after inclusion of 18 out of the 40 planned patients due to insufficient recruitment. The median number of metastases was seven (range=2-30). On intention-to-treat analysis, six patients (33.3%) received local treatment of metastases with complete clearance of metastases in each case. Median progression-free and overall survivals were 15.3 months and 33.7 months, respectively.


CONCLUSION
The assessed strategy is feasible and allows for a complete clearance of metastases in one third of patients, with prolonged survival.