Jason A. Castellanos, MD, MS, Assistant Professor, Department of Surgical Oncology
Fox Chase Cancer Center is renowned for its use of the latest treatment methods for a range of liver and related cancers. We are one of the few hospitals in the Philadelphia region offering hepatic arterial infusion (HAI) pump chemotherapy for the treatment of colorectal liver metastases.
Our program involves a coordinated, multidisciplinary team approach to care—with close collaboration among medical and radiological oncologists, interventional radiologists and pathologists.
Reopening the Possibility of Surgery
Colorectal cancer is the third most common cancer in the United States. About half of patients with colorectal cancer will eventually develop metastases in the liver either on presentation or later; however, only 15 to 20 percent are immediately resectable.
“Chemotherapy does not convert every patient to resection,” said Jason A. Castellanos, MD, MS, assistant professor in the Department of Surgical Oncology at Fox Chase. “Hepatic arterial infusion pump chemotherapy is a way to increase chemotherapy dosage to the liver for an improved response.”
Hepatic artery infusion pump therapy can convert non-resectable colorectal liver metastases to resectable disease. Patients may become candidates for surgery—which is the only treatment offering a chance at a long-term cure.
Ideal Patients for HAI Pump Therapy
Many patients with colorectal liver metastases do not receive a surgical referral and may not realize they are candidates for liver surgery. Patients who benefit most from hepatic arterial infusion pump therapy include those who have liver metastases that are confined to the liver but that cannot be removed from the liver surgically.
How It Works
A hepatic artery infusion pump is about the size of a hockey puck. The pump is implanted surgically under the skin in the left abdomen and connected by a small catheter into the hepatic artery, which supplies blood to the liver.
The pump is filled with chemotherapy that is released slowly and steadily into the hepatic artery. This method delivers a higher dose of chemotherapy to the tumor but does not have the typical side effects of chemotherapy since it is almost completely metabolized by the liver.
Patients are treated with pump chemotherapy on and off every two weeks for up to six months. “Treatment is given in combination with systemic chemotherapy, so we are able to target tumor cells that may be outside of the liver while also focusing on shrinking liver tumors,” Dr. Castellanos said.
Throughout treatment, patients are closely monitored and undergo frequent lab work to make sure the liver and bile ducts remain healthy. They undergo periodic CT scans and MRIs to determine if their response to treatment has enabled us to remove all of their liver tumors.
Why Choose Fox Chase
Fox Chase is one of the few hospitals in the Philadelphia region offering hepatic artery infusion pump chemotherapy for the treatment of colorectal liver metastases. If your patient is eligible for this procedure, our experienced team will lead them through every step of the process.
To increase flexibility for our patients, we offer remote consultation through our telehealth platform. We also offer minimally invasive and robotic surgical interventions as indicated.
The treatment of liver and bile duct cancers and colorectal liver metastases is complex, but our multidisciplinary team will deliver the best possible care tailored to your patient’s needs.