Hepatic artery infusion (HAI) is a treatment for patients with colon or rectal cancer that has spread to the liver and for patients with bile duct cancer (cholangiocarcinoma) that can't be removed or has spread into the liver. When these tumors are numerous, can't be surgically removed, or can't be wiped out by standard chemotherapy methods, HAI may effectively treat them by delivering a concentrated chemotherapy agent directly to the liver. In addition, to improve outcomes for patients having surgery, we may use HAI as an additional treatment after the procedure or as a bridge to surgery.
To initiate the therapy, a pump the size of a hockey puck is implanted under abdominal skin. The pump gradually releases a chemotherapy drug that is carried by a catheter (a thin, flexible tube) into the hepatic artery, the main vessel that supplies blood to tumors in the liver. (A different blood vessel supplies the liver's healthy parts.)
An advantage of HAI is that it's a targeted therapy. Chemotherapy is usually given intravenously (into a vein), which means the dose is diluted through the entire body and only a fraction reaches tumors in the liver. Because the drug's toxicity affects the whole body, we have to limit the dose. HAI pumps chemotherapy straight into the liver, making it possible to hit the tumors with much higher doses (up to 400 times higher than IV doses). Whatever amount the tumors don't absorb is metabolized by the liver, reducing side effects for other organs and tissues.
HAI may offer hope for patients with few treatment options. It can be used before surgery to shrink tumors, after surgery to kill any lingering cancer cells, or instead of surgery for liver tumors that are too extensive or numerous to be removed. By shrinking or even eliminating tumors, this therapy may extend patients' lives, ease their symptoms and, in some cases, keep the tumors from coming back.
Our gastrointestinal cancer team includes international leaders in the fields of surgical and medical oncology for the liver, pancreas and bile ducts. These experts are among the country's most experienced providers of HAI therapy. Indeed, UCSF is the only medical center in Northern California and one of just a few in the West offering this treatment.
