RATIONALE: Hepatic arterial infusion uses a catheter to deliver anticancer substances directly into the liver. Drugs used in chemotherapy, such as melphalan, work in different ways to stop tumor cells from dividing so they stop growing or die. Giving drugs in different ways may kill more tumor cells. PURPOSE: This phase II trial is studying how well giving an hepatic arterial infusion of melphalan together with hepatic perfusion works in treating patients with unresectable liver cancer.
OBJECTIVES: Primary * Determine the response rate and duration of response in patients with unresectable primary or metastatic liver cancer treated with intrahepatic arterial infusion of melphalan with venous filtration via peripheral hepatic perfusion. Secondary * Determine the patterns of recurrence in patients treated with this regimen. * Determine progression-free and overall survival of patients treated with this regimen. * Evaluate the safety and tolerability of this regimen in these patients. * Assess the filter characteristics including melphalan pharmacokinetics and filtration of cytokines and clotting factors during and after treatment. OUTLINE: Patients are stratified according to primary tumor histology (neuroendocrine tumor vs primary hepatic malignancy vs adenocarcinoma of gastrointestinal or other origin). Patients undergo peripheral isolated hepatic perfusion in which a catheter is placed via the groin into the hepatic artery and another into the hepatic vein. Patients then receive melphalan as an intrahepatic arterial infusion over 15-30 minutes. Treatment repeats approximately every 3-8 weeks for up to 6 total infusions in the absence of disease progression or unacceptable toxicity. Patients are followed every 3 months for 2 years, every 4 months for 1 year, and then periodically thereafter. PROJECTED ACCRUAL: A total of 105 patients will be accrued for this study within 4-5 years.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office
Bethesda, Maryland, United States
To determine the response rate and duration of response to intra-hepatic infusion of melphalan with subsequent venous hemofiltration in patients with primary and metastatic hepatic malignancies
Time frame: Survivial
To determine the patterns of recurrence following percutaneous hepatic perfusions (PHP) with melphalan
Time frame: Survival
To determine the progression free and overall survival in patients with hepatic malignancies following this therapy
Time frame: Survivial
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