Therapy-resistant liver metastases in colorectal carcinoma: DEBIRI can help

Researchers investigated whether drug-eluting beads loaded with irinotecan (DEBIRI), and continuously release it, lead to improved therapy success.

What do we know about DEBIRI?

The beads are a local therapy option.
Their application did not lead to prolonged survival.
However, more than 50% of the liver metastases responded to treatment.

A therapy option when bevacizumab does not work

Bevacizumab-based chemotherapy (BBC) does not always lead to a good response in colorectal cancer metastases. Researchers from Taiwan have now investigated whether and how DEBIRI beads work on synchronous liver metastases. For this purpose, they studied 42 people with colorectal carcinoma and liver metastases who had not responded to BBC, whereby the participants were not allowed to have any other metastases. 19 of the 42 people with the disease received DEBIRI treatment. The outcomes were finally compared with the data from patients who had responded well to BBC.

Survival is not improved

A comparison of the data showed that

Treatment with DEBIRI does not prolong survival (p = 0.01). This applies to both progression-free survival and overall survival.
Of 33 metastases treated, 54% reacted and responded to local bead therapy.

Conclusion for medical practice

DEBIRI may be a good local treatment option for synchronous liver metastases in colorectal cancer. Nevertheless, the treatment does not improve survival. Rather its use leads to a regional response of BBC-resistant metastases in the liver.

Source

Chen PK et al: Drug-eluting beads loaded with irinotecan to treat synchronous liver-only metastases of colorectal cancer non-responsive to bevacizumab-based chemotherapy. Br J Radiol. 2023 Feb 20:20220767.