P-0245 Vegf Serum Level after Chemoembolization With Drug-Eluting Beads (Debiri) in Patients With Liver Metastases of Chemotherapy Refractory Colorectal Cancer

Abstract

ABSTRACT Introduction Transcatheter arterial chemoembolization (TACE) with Irinotecan loaded drug eluting beads has shown activity in colorectal liver metastases. Among the factors potentially interfering with its effectiveness is a hypothetical nonangiogenic reaction due to ischemia. In this study we evaluated the changes in VEGF serum levels in patients treated with TACE. Methods Patients with predominant and life threatening liver metastases from CRC which were refractory to all drugs approved for metastasized CRC and documented tumor progression during or shortly after the last chemotherapy, were prospectively treated with Irinotecan loaded drug eluting beads with a size of 100-300 µm. All Patients gave written informed consent. Therapy was applied by a temporary catheter placed in the liver arteries. Usually each lobe of the liver was treated two times with an interval of 4 weeks, according to the recommended DEBIRI treatment algorithm. Each treatment of one liver lobe was performed with 1 vial of the 100-300 µm DC-Beads loaded with 100 mg Irinotecan. Blood samples to measure the VEGF serum levels were taken before TACE and at day 7, 14 and 21 after first treatment (Test-Kit: Human VEGF-A Platinum ELISA, Bender MedSystems). Results Complete blood samples to evaluate the VEGF-A-Levels were taken from 15 Patients ( 12 male/ 3 female; median age 61) from 2/11 to 2/12. 66% (10/15) of patients had an increase of the VEGF-Level with a median of 107, 37%, 33 % (5/15) of patient had a decrease of the VEGF-Level with a median of - 38, 94%. Conclusion These first findings show different behavior of the serum VEGF level after the TACE with Irinotecan loaded Drug eluting Beads, suggesting that the occlusion of blood vessels and subsequent ischemia induces neo-angiogenesis due to these growth factors in 66% of Patients and a subset of 33% with a decrease of VEGF Levels. Updated results concerning correlation of changes of the VEGF-Level with tumor necrosis, response rate or time to progression will be presented. These preliminary results could implicate that antiangiogenic drugs might be effective as an additive therapy to chemoembolization in a subset of patients.