Chemotherapy for breast cancer progresses to liver metastases after surgery and systemic treatment

Tao Yin; Lei Nie; Dongde Wu; Baozhen Liu; Yaojun Feng; Xinhong Wu; Chenggang Luo; Jianjun Liang

doi:10.21037/tcr.2019.12.59

Chemotherapy for breast cancer progresses to liver metastases after surgery and systemic treatment

Transl Cancer Res. 2020 Feb;9(2):993-1000. doi: 10.21037/tcr.2019.12.59.

Authors

Tao Yin^#¹, Lei Nie^#¹, Dongde Wu¹, Baozhen Liu², Yaojun Feng³, Xinhong Wu³, Chenggang Luo¹, Jianjun Liang⁴

Affiliations

¹ Department of Hepatobiliary and Pancreatic Surgery, Hubei Cancer Hospital of Hua Zhong University of Science & Technology (Hubei Cancer Hospital), Wuhan 430079, China.
² School Hospital of Wuhan Textile University, Wuhan 430079, China.
³ Department of Breast Cancer Surgery, Hubei Cancer Hospital of Hua Zhong University of Science & Technology (Hubei Cancer Hospital), Wuhan 430079, China.
⁴ First Hospital of Wuxue County, Huanggang 430079, China.

^# Contributed equally.

Abstract

Background: This study aims to evaluate the effectiveness of hepatic arterial infusion chemotherapy/portal vein infusion chemotherapy (HAIC/PVIC), transcatheter hepatic arterial chemoembolization (TACE) and transcatheter arterial embolization (TAE) for unresectable breast cancer liver metastases (UBCLM).

Methods: The present study included 57 patients. These patients were randomly divided into three groups (n=19, each): HAIC/PVIC group, TACE group and TAE group. Patients in the HAIC/PVIC group were treated with the same systemic chemotherapy regimen previously received by infusion through an intra-arterial and portal vein catheter. Patients in the TACE group received cyclophosphamide, epirubicin and 5-fluorouracil, and embolization. Patients in the TAE group were only treated with embolization.

Results: The median number of treatments was 6 (range, 3-13) in the HAIC/PVIC group, 5 (range, 4-9) in the TACE group, and 6 (range, 4-8) in the TAE group. The 1-, 2- and 3-year survival rates for these groups were 18/19 (94.7%), 14/19 (73.7%) and 11/19 (57.9%), 14/19 (73.7%), 9/19 (47.4%) and 8/19 (42.1%), and 8/19 (42.1%), 4/19 (21.1%) and 0/19 (0%), respectively. The median overall survival from the original breast cancer diagnosis was 88 (range, 11-133), 75 (range, 9-115), and 49 (range, 10-64) months in the HAIC/PVIC, TACE and TAE groups, respectively. Grade I-II and grade III-IV bone marrow suppression was observed in 12/19 (63.2%) and 3/19 (15.8%) patients in the HAIC/PVIC group, respectively, in 17/19 (89.5%) and 5/19 (26.3%) patients in the TACE group, respectively, and in 0/19 (0%) and 0/19 (0%) patients in the TAE group, respectively.

Conclusions: HAIC/PVIC with the same regional chemotherapy regimen of the original systemic treatment is feasible, and can benefit patients with UBCLM, who have progressed on prior systemic therapies.

Keywords: Unresectable breast cancer liver metastases (UBCLM); hepatic arterial infusion chemotherapy/portal vein infusion chemotherapy (HAIC/PVIC); prognosis.