Dr. Cavnar on the Use of Hepatic Artery Infusion Pumps in CRC With Liver Metastases

Michael J. Cavnar, MD, an assistant professor of surgery at the University of Kentucky Markey Cancer Center, discusses the use of hepatic artery infusion pumps in patients with colorectal cancer (CRC) with liver metastases.

Hepatic artery infusion pumps have been in use since the 1970s, Cavnar says. The device capitalizes on the fact that liver metastases get their blood supply from the artery that feeds the liver. Specifically, the liver has a dual inflow of blood, one-third of which comes from the hepatic artery and two-thirds come from the portal vein, explains Cavnar. For reasons that are not currently understood, CRC liver metastases only receive blood flow from the hepatic artery, according to Cavnar.

Starting in the 1970s, chemotherapy was infused directly into the liver. The rationale behind this is that a higher dose can be administered without added toxicity to the rest of the body. The dose that would need to be administered to a vein or meta port to achieve the same level of response would be incredibly toxic to the patient, Cavnar says. Instead, the pump allows for the administration of a small amount of chemotherapy at a high concentration into the liver to achieve a dramatic response, Cavnar concludes.