How do you treat liver metastases that cannot be surgically removed?
Nancy Kemeny, MD:
So, one way you can treat that patient is with systemic chemotherapy. That means chemotherapy through the whole body with one of the new molecular targeted agents,either against epidermal growth factor receptor or either against vascular endothelial growth factor,Avastin and use that with the chemotherapy with the hope that you will shrink the tumor enough so that perhaps they can have surgery.Now the other thing that we're doing at Memorial, is we are using the systemic chemotherapy, which is all over the body, plus the interhepatic chemotherapy,so directing the chemotherapy directly to the liver and using both together, we get a very high response rate. 89% percent of them get a reduction in tumor,and then some of them, like 35% have been able to go on to resection. So even though they were totally unresectable when we started, meaning there was tumor all over the liver,there was no way a surgeon could take it out, we've gotten enough shrinkage they've been able to have a resection.