Northwestern Medicine Offering Breakthrough Cancer Therapy

Lisa Fielding
February 27, 2020 - 2:20 pm

CHICAGO (WBBM NEWSRADIO) -- When you think of chemotherapy, you may think of medication delivered through an IV or a pill, but now there is a way to kill the cancer cells more directly, without exposing toxins to the rest of the body.

"It's called the hepatic artery infusion pump and it's a pump that sits in the abdominal wall which gets filled with chemotherapy every month. It delivers high dose chemotherapy directly to the liver  through a large artery, the hepatic artery," said Dr. Ryan Merkow, MD, MS a surgical oncologist at Northwestern Medicine.

The device, the size of a hockey puck, is implanted in the abdomen to pump high doses of chemotherapy directly into the liver for cancer that has spread there, usually from colon or rectal tumors. The treatment can help prevent tumors from recurring after they are removed from the liver, and can shrink inoperable growths in the liver so that they can be cut out.

(Ryan Merkow)

Dr. Merkow performs hepatic artery infusion pump surgery at Northwestern Memorial Hospital. He says that because the chemotherapy is delivered directly to the liver, it is completely broken down, or metabolized, by the organ, sparing the rest of the body from the toxic effects of the high-dose chemotherapy.

"We call it a regional therapy, meaning it's delivering a treatment directly to an organ, to a compartment. it's completely metabolized in the liver, it goes to the liver but none of the chemo exits the liver. There's no systemic toxicities to that therapy," he said.

This allows the pump to release high concentrations of the drug.

"We can reach concentrations upwards of 3-400 times what the liver would normally see with systemic chemotherapy or chemotherapy through an IV," he said.

The ultimate goal of the therapy is to destroy enough of the cancer cells with medication to allow the surgeon to remove any remaining cancerous tissue, ridding the patient of cancer. However, if complete removal of cancerous tissue is not an option, the pump can at least slow the growth of the cancer and prolong survival.

"This treatment is really for the entire organ, the entire liver, for any disease that is present there with really high doses," the doctor said. "We see response rates much higher than will systemic agents alone."

'There's a growing popularity with this treatment'

 The pump was introduced in the 1980s but has improved since the early 2000s.

"What we've found that even the era of modern systematic chemo, this treatment still is very effective at a number of things. It reduces recurrences after surgery and amongst patients who have too much disease in the liver, where we can't take them to surgery, this helps convert them to complete resection better than just systemic chemo alone. There's a growing popularity with this treatment," said Merkow.

 Northwestern is the only hospital in Illinois offering the therapy and one of only a few in the United States.

"We're the only hospital in Illinois and only one of few hospitals in the entire Midwest, maybe 10 centers that have a robust, mature program across the country that is placing these pumps. it's not a common procedure," he said.

Merkow says in the end, it's about helping patients, making therapy more comfortable and increasing mortality rates.

"If we can avoid toxic, systemic chemotherapy in organs that are totally normal that don't need to see that toxic chemo, than that is a huge win and a huge benefit for these patients," he said.