'Targeted Chemo' Safely Shrinks Liver Tumors

Feb. 4, 2009— -- Linda Campbell had already beaten ocular melanoma, a rare form of skin cancer, or so she thought. Then during the summer, doctors discovered the tumors had spread to her liver.

"There were so many they couldn't count them," said Campbell.

Campbell, who's 59 years old and lives with her husband outside of Lexington, N.C., learned that when cancer spreads to the liver, it becomes much more deadly.

It does not matter whether cancer starts in the breast or colon, lung or skin, the real damage is caused when it metastasizes to the liver. Every year an estimated 200,000 Americans receive the grim diagnosis and few patients survive more than a year.

"There was a lot of crying. ... And we weren't sure what to do," Campbell told ABC News.

Doctors suggested Campbell enroll in a clinical trial testing a new, radically different type of chemotherapy. This experimental technique targets only the cancer site, allowing doctors to flood the liver with 10 times the dose of a standard chemotherapy drug.

"You can perhaps get a better effectiveness, which would improve the longevity of the patient and the quality of life," said Dr. H. Richard Alexander of the University of Maryland Medical Center in Baltimore, Md., one of several now conducting clinical trials on this technique.

"Anytime you get a dose of chemo intravenously, even a teaspoon, it's going to be distributed through the entire body," Alexander said. "You are only going to get a drop or a fraction of a drop into the tumor where you really want it. But if you can direct a teaspoon of chemotherapy to a region of the body where the cancer is actively growing, then you are going to get a much higher dose of that potentially effective chemotherapy directly to the tumor."

The challenge: how to do it safely. Now, doctors say they've found a way.

In this protocol, doctors thread a catheter up to the liver and for the next 30 minutes inject the high doses of the chemotherapy drug directly to the site. To prevent the drug from reaching the rest of the body, doctors "capture" the blood -- now loaded with the chemo drug -- as it leaves the liver. The blood is passed through an external filter then safely returned to the body.

"We can very effectively capture almost all of the blood containing chemo as it comes out of the liver," said Alexander.

In a recently completed Phase I clinical trial, after four monthly treatments, liver tumors shrank in 50 percent of patients. In two patients, the tumors actually disappeared.

And early indications are Campbell's liver tumors have started to respond, and with few side effects.

"I'm surprised at how good I feel afterwards," she said. No hair loss or nausea. Some fatigue and appetite loss appear to be the biggest complaints.

Campbell does not know if, or when, her cancer will start growing again, but she knows the "targeted chemo" could provide precious time.

"I'm not ready to die," she said. "And if this can prolong my life even a couple of years, I'm willing to take it."

Medical centers participating in Stage III clinical trials of targeted chemotherapy: National Cancer Institute, Bethesda, Md.; University of Maryland; Atlantic Melanoma Center (N.J.); Albany Medical Center (N.Y.); University of Texas (Galveston); St. Luke's Cancer Center (Bethlehem, Pa.); Moffitt Cancer Center (Tampa, Fla.); Providence Cancer Center (Ore.); and John Wayne Cancer Institute (Calif.); University of Pittsburgh Medical Center (Pa.); Swedish Medical Center (Denver, Colo.). For more information, visit livercancertrials.com