Attacking Liver Cancer With Highly Concentrated Chemo Dose

Researchers at the National Institutes for Health and other US hospitals are testing a super aggressive form of chemotherapy that targets cancer that has spread to the liver.

In the new approach, known as percutaneous hepatic perfusion, or PHP, doctors use balloons, similar to those used in heart surgery, to seal off the patient’s liver in order to apply a super-high dose of chemotherapy directly into the liver without allowing it to spread to the rest of the body.

Bill Darker, 46, told the AP that he has flown from his home in Imperial Beach, California to NIH in Washington three times to be a part of the experimental treatment. Before his last round, Darker's liver tumors had shrunk by about a third.

"I've always wanted to treat this cancer very aggressively since I know the prognosis is very dim," said Darker. "I just take the gloves off and go for it."

Darker is one of thousands of US patients each year who learn that cancer from various origins has spread to the liver. Often, cancer this aggressive hits multiple organs. But up to 40,000 patients a year have a life-threatening metastasis confined just to the liver. Those patients are the target of the new approach being studied by doctors at NIH.

NIH's Dr. Elliot Levy uses X-ray images to inflate the balloons at the top and bottom of Darker’s liver, which blocks the blood from exiting as usual. Dye is injected to make sure that the seal is properly maintained.

“The tube's holes capture chemo-saturated blood and reroute it out of the body, to a pump where filters scrub away the drug. Filtered blood re-enters the body through a tube in the neck,” said the AP.

Once the seal is in place, the oncologist drips a highly concentrated chemotherapy dose into the hepatic artery, saturating the liver.

"The ability to shrink cancers in the livers of patients who failed other therapies is exciting," Dr. Neal Meropol, gastrointestinal cancer chief at Fox Chase Cancer Center, who isn't involved with the study, told the AP. He said cancer specialists are watching the work very skeptically, because it's such a complex procedure.

Pumps are allowed to run for an additional half hour following the chemotherapy dose in order to remove 80 percent to 90 percent, but not all of it is removed, which means that patients will still suffer some fatigue and a weakened immune system after the treatment.

According to the AP, PHP, if approved could cost under $20,000.