Possible treatments for you to discuss with your physician about which ones are right for you. When you are discussing treatment plans, always check ahead to make sure that the treatment plan you looking to use will not disqualify you for a clinical trial in the future. Having a next step treatment plan is a good way to be ready if your current treatment stops working. Your physician can help you develop a treatment plan with next steps and possible clinical trials that are right for you.
Liver Directed therapy
Embolization – chemotherapy, radiation, immunotherapy
Regional isolation Perfusion
IHP can only be done one, HIA PHP are less invasive and may be performed multiple times.
Isolated hepatic infusion (IHP), open surgical procedure involving vascular isolation of the liver with high doses of chemotherapy delivered directly to the liver. Most commonly done with Mmelphalan
PHP double ballon catheter inserted into the inferior vena cava to isolate the blood supply to the live and then is filtered extracorporeally. Better tolerated than IHP but reports are lacking efficacy results.
Hepatic chemoemolization drug eluting beads, gelatin sponge, polyvinyl sponge, resorbable microspheres and polyvinyl alcohol particles. Chemoembolization has been well tolerated.
Immunologic stimulant into the hepatic artery followed by an emboli zing agent.
Hepatic Radioembolization or hepatic trans-arterial radioemboliztion (TARE) or selective internal RT (SIRT) glass or resin yttrium-90 needs are introduced to the hepatic artery.
There is also resection of the tumor that might be appropriate. This is usually done when there are few tumors and are easily accessible. Not all tumors can be resected. Embolization might be done as well.
Immunotherapy is an option your physician might recommend
Aniti PD-1 mono therapy
Tentafusp (IMCgp100) is only available from centers who participated in the clinical trial under special use. Contact your physician if you would like more information. It is currently not FDA approved.
Dendritic Cell Vaccination