Limited potential of hepatic arterial infusion of irinotecan.

SummaryIntravenously administered irinotecan has gained an important place in the struggle against metastatic and/or irresectable colorectal cancer. In patients with irresectable metastases confined to the liver, hepatic arterial infusion (HAI) of this anti-cancer agent has considered to be an option. Partly based on conducted phase I- and II-studies, here we conclude that irinotecan as single agent HAI therapy has limited potential compared to intravenous administration. From a pharmacokineticpharmacodynamic point of view, in particular the long half-life of the active metabolite, SN-38, its use is limited as well. In our view, future clinical implementation of irinotecan as HAI chemotherapy is unrealistic.