Cyramza is a biologic drug that is administered by intravenous infusion. It is an angiogenesis inhibitor, and similar to bevacizumab (Avastin), this drug hinders new blood vessel growth so that the blood supply that usually sustains tumor growth is blocked. Cyramza is used with FOLFIRI to treat metastatic colorectal cancer when the cancer continues to progress during or after other treatments.
Lonsurf is an oral chemotherapy drug. It is designed to treat patients with metastatic colon cancer whose cancer has continued to advance after approved standard therapies. Similar to 5-FU, it works by incorporating itself into the DNA of cancer cells, stopping them from growing.
During Hepatic Arterial Infusion (HAI) chemotherapy, a high dose of chemotherapy drugs are pumped into the hepatic artery — the main source of blood and nutrients for liver tumors — through a tiny pump under the skin in the lower abdomen. Additional chemotherapy medicine is injected into the pump, as needed, on an outpatient basis. Because HAI chemotherapy is delivered regionally (only to the tumor site), it causes fewer toxic side effects and has been associated with better physical functioning than systemic chemotherapy.
In a number of patients who cannot have liver metastases removed because of their number, size, or location, HAI plus systemic therapy can reduce tumors so resection can become possible.
Small particles or beads, ranging in size from 100 to 900 microns made of a biocompatible resin, are injected into selected vessels to block the blood flow feeding the tumors, causing the tumor to shrink.
Over a series of months, the embolized vessels will permanently shrink and the tumor will decrease in size. Embolization can be performed with bland particles (without drug added), or with drug added which is called TACE (Transarterial Chemoembolization). Cutting off the blood supply to the tumor allows for higher doses of chemotherapy to be delivered and remain in contact with the tumor, and preventing the chemotherapy from reaching healthy tissue.
SIRT (Selective Internal Radiation Therapy) is a targeted radiation therapy that uses SIR-Spheres® microspheres to treat metastatic liver cancer.
During the procedure, a small flexible tube is guided through the artery into the liver and millions of microscopic spheres (each about a third of the width of a human hair) are delivered directly into the tumor where they become trapped. The SIR-Spheres microspheres emit beta radiation for a period of about two weeks.
This targeted therapy delivers a dose of internal radiation up to 40 times higher than conventional external beam therapy. Normal liver tissue takes about 90% of its blood supply from the veins, while liver tumors receive about 90%of their blood supply from arteries. This allows SIR-Spheres microspheres to target the liver tumors with a tumor-killing dose of radiation via the hepatic artery, while sparing surrounding healthy liver tissue.
Microwave Ablation (MA) uses microwave energy and an antenna to cause coagulation of tissue by creating heat due to friction and vibration of water molecules in the cells. The advantage of MA over other heating systems, such as RFA, is that the microwave technique is quicker (it can be completed in 10 minutes) and does not cause collateral damage.
Cryotherapy or cryosurgery uses super cooled nitrogen or argon gas to freeze liver lesions thereby destroying the tumor. Similar to Radiofrequency Ablation (RFA), the procedure can be performed through a needle. A doctor will use MRI or ultrasound to guide the probe and monitor the formation of an “ice ball” in the tumor, limiting damage to surrounding tissue. The procedure may also be performed using an open surgical procedure. Clinical and laboratory research suggest that hepatic cryotherapy is effective in patients with inoperable tumors, which are located in a difficult section of the liver (near large vessels).
Radiofrequency Ablation (RFA) uses electrical energy to “super heat” and attack the tumor. The procedure can be performed by inserting a needle through the skin under x-ray guidance, then placing a probe through the needle and positioning it in the liver tumor. The procedure is usually performed by an interventional radiologist under local anesthesia. Alternatively, the procedure can be done laparoscopically, using a laparoscope that is inserted through a tiny incision in the abdomen. It may also be done as an open surgical procedure. The laparoscopic and open surgical procedures are performed by a surgeon.
Avastin is a tumor-starving (or anti-angiogenic) biologic therapy. Cancers need blood in order to grow. To get enough blood, tumors tell the body to grow new blood vessels. Angiogenesis inhibitors block this process. Avastin blocks a protein called vascular endothelial growth factor, or VEGF. Normal cells produce VEGF, but some cancer cells overproduce VEGF. Blocking VEGF may prevent the growth of new blood vessels that feed tumors.
Avastin is administered through an injection every two weeks in combination with other chemotherapies.
CapeOx is a chemotherapy regimen of capecitabine and oxaliplatin. Capecitabine is given orally and oxaliplatin is given through injection or IV into a port in your chest.
Cape = Capecitabine
Ox = Oxaliplatin