New cancer treatment delivers direct chemotherapy to the liver
A new treatment for colorectal cancer that has spread to the liver is showing promising results in Dutch medical trials. The PUMP-IT study, led by surgeon Koert Kuhlmann at Antoni van Leeuwenhoek, investigates a method that delivers high-dose chemotherapy directly to the liver via a surgically implanted pump.
“Colorectal cancer can spread to the liver, and if there are too many metastases, surgical removal is not an option,” Kuhlmann said. “This study examines the value of a new treatment for patients with liver metastases. A pump, approximately 8 centimeters in diameter, is placed under the skin in the abdomen. A catheter connects the pump to the artery leading to the liver, allowing continuous delivery of chemotherapy. It’s an advanced device that doesn’t even require a battery.”
The pump delivers floxuridine, a chemotherapy drug that has been in use for years. The treatment is highly localized, allowing for significantly higher dosages than traditional intravenous chemotherapy. “The difference with the standard treatment is that this method targets the liver directly.
The administered dose is up to 400 times higher, making it highly effective,” Kuhlmann said. “Because the liver breaks down the drug immediately, systemic side effects are minimal. Patients also receive standard intravenous chemotherapy alongside the pump treatment.”
In an earlier pilot study conducted with Erasmus MC, the treatment was tested on 31 patients. “We proved the safety and feasibility of this treatment, which had never been done in the European Union before,” Kuhlmann said. “The results were impressive. That’s why we recently started a nationwide follow-up study comparing this pump therapy to standard chemotherapy to assess its impact on survival.”
The follow-up study, funded by a 2.3 million euros grant from the Dutch Cancer Society (KWF), is set to run for five years across 20 liver treatment centers in the Netherlands.
If the study proves the pump treatment is more effective than standard chemotherapy, efforts will be made to ensure its rapid approval by Dutch health insurers. “Right now, this treatment is only available within the study,” Kuhlmann said. “If we confirm its benefits, we will push for it to be widely available as soon as possible.”
The treatment aims to significantly extend life expectancy. “For patients receiving standard chemotherapy, the average survival is 30 months. With the pump, we estimate it could be 48 months,” Kuhlmann said. “The study will provide the final proof, but our goal is clear: to help patients with this form of cancer live longer.”
The therapy is currently only available through clinical trials. The pump costs just over 5,000 euros, and each chemotherapy dose costs 150 euros, making it a relatively affordable treatment compared to other therapies like immunotherapy.
To qualify for the study, patients must meet strict criteria. “Participants must not have undergone chemotherapy before, and the cancer must be limited to the liver, meaning no metastases in other organs like the lungs,” Kuhlmann explained.
