The Experts below are selected from a list of 381 Experts worldwide ranked by ideXlab platform
Nancy E Kemeny - One of the best experts on this subject based on the ideXlab platform.
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regional chemotherapy for unresectable intrahepatic cholangiocarcinoma a potential role for dynamic magnetic resonance imaging as an imaging biomarker and a survival update from two prospective clinical trials
Annals of Surgical Oncology, 2014Co-Authors: Ioannis Konstantinidis, David H Gultekin, Peter J. Allen, Yuman Fong, Ronald P. Dematteo, Michael I Dangelica, Lawrence H Schwartz, Mithat Gonen, David S Klimstra, Nancy E KemenyAbstract:Background For patients with unresectable intrahepatic cholangiocarcinoma (ICC), treatment options are limited and survival is poor. This study summarizes the long-term outcome of two previously reported clinical trials using hepatic arterial infusion (HAI) with Floxuridine and dexamethasone (with or without bevacizumab) in advanced ICC.
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biliary sclerosis after hepatic arterial infusion pump chemotherapy for patients with colorectal cancer liver metastasis incidence clinical features and risk factors
Annals of Surgical Oncology, 2012Co-Authors: Nancy E Kemeny, Peter J. Allen, Philip Paty, Yuman Fong, William R. Jarnagin, Ronald P. Dematteo, Mithat Gonen, Michael I DangelicaAbstract:Background Hepatic arterial infusion pump chemotherapy (HAIPC) contributes to the prolonged survival of selected patients with colorectal cancer liver metastases (CRCLM). The most clinically important adverse event after HAIPC with Floxuridine (FUDR) is biliary sclerosis (BS). Little is known about the etiology of BS.
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treating primary liver cancer with hepatic arterial infusion of Floxuridine and dexamethasone does the addition of systemic bevacizumab improve results
Oncology, 2011Co-Authors: Nancy E Kemeny, Alexandra N. Gewirtz, David H Gultekin, Dana Haviland, Adam C. Yopp, Yuman Fong, Michael I Dangelica, Lawrence H Schwartz, Mithat Gonen, Peter J. AllenAbstract:Objectives: This study investigated the efficacy and safety of adding systemic (IV) bevacizumab (Bev) to hepatic arterial infusion (HAI) with Floxuridine (FUDR)/dexamethasone (Dex)
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antiangiogenic therapy for primary liver cancer correlation of changes in dynamic contrast enhanced magnetic resonance imaging with tissue hypoxia markers and clinical response
Annals of Surgical Oncology, 2011Co-Authors: Adam C. Yopp, David H Gultekin, Dana Haviland, Nancy E Kemeny, Michael I Dangelica, Lawrence H Schwartz, Mithat Gonen, Zubin M Bamboat, Jinru Shia, Yuman FongAbstract:Background This study utilized the imaging data of primary liver cancer (PLC) treated with Floxuridine (FUDR) and bevacizumab to test the hypothesis that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters correlate with tissue hypoxia markers and treatment outcome.
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incidence and risk factors for biliary sclerosis following adjuvant hepatic arterial infusion with Floxuridine after hepatectomy for metastatic colorectal cancer
Journal of Clinical Oncology, 2010Co-Authors: K Ito, Peter J. Allen, Nancy E Kemeny, Yuman Fong, Mithat Gonen, Hiromichi Ito, R P Dematteo, Leslie H Blumgart, W R Jarnagin, Michael I DangelicaAbstract:3556 Background: Adjuvant hepatic arterial infusion pump chemotherapy (HAIPC) with Floxuridine (FUDR) contributes to the prolonged progression-free survival of patients with resected colorectal can...
Gordon L. Amidon - One of the best experts on this subject based on the ideXlab platform.
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the dipeptide monoester prodrugs of Floxuridine and gemcitabine feasibility of orally administrable nucleoside analogs
Pharmaceuticals, 2014Co-Authors: Yasuhiro Tsume, Blanca Borras Bermejo, Gordon L. AmidonAbstract:Dipeptide monoester prodrugs of Floxuridine and gemcitabine were synthesized. Their chemical stability in buffers, enzymatic stability in cell homogenates, permeability in mouse intestinal membrane along with drug concentration in mouse plasma, and anti-proliferative activity in cancer cells were determined and compared to their parent drugs. Floxuridine prodrug was more enzymatically stable than Floxuridine and the degradation from prodrug to parent drug works as the rate-limiting step. On the other hand, gemcitabine prodrug was less enzymatically stable than gemcitabine. Those dipeptide monoester prodrugs exhibited 2.4- to 48.7-fold higher uptake than their parent drugs in Caco-2, Panc-1, and AsPC-1 cells. Floxuridine and gemcitabine prodrugs showed superior permeability in mouse jejunum to their parent drugs and exhibited the higher drug concentration in plasma after in situ mouse perfusion. Cell proliferation assays in ductal pancreatic cancer cells, AsPC-1 and Panc-1, indicated that dipeptide prodrugs of Floxuridine and gemcitabine were more potent than their parent drugs. The enhanced potency of nucleoside analogs was attributed to their improved membrane permeability. The prodrug forms of 5¢-L-phenylalanyl-l-tyrosyl-Floxuridine and 5¢-L-phenylalanyl-L-tyrosyl-gemcitabine appeared in mouse plasma after the permeation of intestinal membrane and the first-pass effect, suggesting their potential for the development of oral dosage form for anti-cancer agents.
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The Dipeptide Monoester Prodrugs of Floxuridine and Gemcitabine—Feasibility of Orally Administrable Nucleoside Analogs
MDPI AG, 2014Co-Authors: Yasuhiro Tsume, Blanca Borras Bermejo, Gordon L. AmidonAbstract:Dipeptide monoester prodrugs of Floxuridine and gemcitabine were synthesized. Their chemical stability in buffers, enzymatic stability in cell homogenates, permeability in mouse intestinal membrane along with drug concentration in mouse plasma, and anti-proliferative activity in cancer cells were determined and compared to their parent drugs. Floxuridine prodrug was more enzymatically stable than Floxuridine and the degradation from prodrug to parent drug works as the rate-limiting step. On the other hand, gemcitabine prodrug was less enzymatically stable than gemcitabine. Those dipeptide monoester prodrugs exhibited 2.4- to 48.7-fold higher uptake than their parent drugs in Caco-2, Panc-1, and AsPC-1 cells. Floxuridine and gemcitabine prodrugs showed superior permeability in mouse jejunum to their parent drugs and exhibited the higher drug concentration in plasma after in situ mouse perfusion. Cell proliferation assays in ductal pancreatic cancer cells, AsPC-1 and Panc-1, indicated that dipeptide prodrugs of Floxuridine and gemcitabine were more potent than their parent drugs. The enhanced potency of nucleoside analogs was attributed to their improved membrane permeability. The prodrug forms of 5¢-L-phenylalanyl-l-tyrosyl-Floxuridine and 5¢-L-phenylalanyl-L-tyrosyl-gemcitabine appeared in mouse plasma after the permeation of intestinal membrane and the first-pass effect, suggesting their potential for the development of oral dosage form for anti-cancer agents
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the feasibility of enzyme targeted activation for amino acid dipeptide monoester prodrugs of Floxuridine cathepsin d as a potential targeted enzyme
Molecules, 2012Co-Authors: Yasuhiro Tsume, Gordon L. AmidonAbstract:The improvement of therapeutic efficacy for cancer agents has been a big challenge which includes the increase of tumor selectivity and the reduction of adverse effects at non-tumor sites. In order to achieve those goals, prodrug approaches have been extensively investigated. In this report, the potential activation enzymes for 5¢-amino acid/dipeptide monoester Floxuridine prodrugs in pancreatic cancer cells were selected and the feasibility of enzyme specific activation of prodrugs was evaluated. All prodrugs exhibited the range of 3.0–105.7 min of half life in Capan-2 cell homogenate with the presence and the absence of selective enzyme inhibitors. 5¢-O-L-Phenylalanyl-L-tyrosyl-Floxuridine exhibited longer half life only with the presence of pepstatin A. Human cathepsin B and D selectively hydrolized 5¢-O-L-phenylalanyl-L-tyrosylFloxuridine and 5¢-O-L-phenylalanyl-L-glycylFloxuridine compared to the other tested prodrugs. The wide range of growth inhibitory effect by Floxuridine prodrugs in Capan-2 cells was observed due to the different affinities of prodrug promoieties to enyzmes. In conclusion, it is feasible to design prodrugs which are activated by specific enzymes. Cathepsin D might be a good candidate as a target enzyme for prodrug activation and 5¢-O-L-phenylalanyl-L-tyrosylFloxuridine may be the best candidate among the tested Floxuridine prodrugs.
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The Feasibility of Enzyme Targeted Activation for Amino Acid/Dipeptide Monoester Prodrugs of Floxuridine; Cathepsin D as a Potential Targeted Enzyme
MDPI AG, 2012Co-Authors: Gordon L. Amidon, Yasuhiro TsumeAbstract:The improvement of therapeutic efficacy for cancer agents has been a big challenge which includes the increase of tumor selectivity and the reduction of adverse effects at non-tumor sites. In order to achieve those goals, prodrug approaches have been extensively investigated. In this report, the potential activation enzymes for 5¢-amino acid/dipeptide monoester Floxuridine prodrugs in pancreatic cancer cells were selected and the feasibility of enzyme specific activation of prodrugs was evaluated. All prodrugs exhibited the range of 3.0–105.7 min of half life in Capan-2 cell homogenate with the presence and the absence of selective enzyme inhibitors. 5¢-O-L-Phenylalanyl-L-tyrosyl-Floxuridine exhibited longer half life only with the presence of pepstatin A. Human cathepsin B and D selectively hydrolized 5¢-O-L-phenylalanyl-L-tyrosylFloxuridine and 5¢-O-L-phenylalanyl-L-glycylFloxuridine compared to the other tested prodrugs. The wide range of growth inhibitory effect by Floxuridine prodrugs in Capan-2 cells was observed due to the different affinities of prodrug promoieties to enyzmes. In conclusion, it is feasible to design prodrugs which are activated by specific enzymes. Cathepsin D might be a good candidate as a target enzyme for prodrug activation and 5¢-O-L-phenylalanyl-L-tyrosylFloxuridine may be the best candidate among the tested Floxuridine prodrugs
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potential of amino acid dipeptide monoester prodrugs of Floxuridine in facilitating enhanced delivery of active drug to interior sites of tumors a two tier monolayer in vitro study
Pharmaceutical Research, 2011Co-Authors: Yasuhiro Tsume, John M. Hilfinger, Gordon L. AmidonAbstract:Purpose To evaluate the advantages of amino acid/dipeptide monoester prodrugs for cancer treatments by assessing the uptake and cytotoxic effects of Floxuridine prodrugs in a secondary cancer cell monolayer following permeation across a primary cancer cell monolayer.
Michael I Dangelica - One of the best experts on this subject based on the ideXlab platform.
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regional chemotherapy for unresectable intrahepatic cholangiocarcinoma a potential role for dynamic magnetic resonance imaging as an imaging biomarker and a survival update from two prospective clinical trials
Annals of Surgical Oncology, 2014Co-Authors: Ioannis Konstantinidis, David H Gultekin, Peter J. Allen, Yuman Fong, Ronald P. Dematteo, Michael I Dangelica, Lawrence H Schwartz, Mithat Gonen, David S Klimstra, Nancy E KemenyAbstract:Background For patients with unresectable intrahepatic cholangiocarcinoma (ICC), treatment options are limited and survival is poor. This study summarizes the long-term outcome of two previously reported clinical trials using hepatic arterial infusion (HAI) with Floxuridine and dexamethasone (with or without bevacizumab) in advanced ICC.
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Floxuridine hepatic arterial infusion associated biliary toxicity is increased by concurrent administration of systemic bevacizumab
Annals of Surgical Oncology, 2014Co-Authors: Andrea Cercek, Dina Patel, Alexandra N. Gewirtz, Peter J. Allen, Marinela Capanu, Yuman Fong, Ronald P. Dematteo, Michael I Dangelica, Derek G. Power, William R. JarnaginAbstract:Purpose Systemic bevacizumab (Bev) was added to hepatic arterial infusion (HAI) Floxuridine (FUDR)-based chemotherapy in three studies in an attempt to improve outcomes. A specific review of biliary toxicity was carried out.
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biliary sclerosis after hepatic arterial infusion pump chemotherapy for patients with colorectal cancer liver metastasis incidence clinical features and risk factors
Annals of Surgical Oncology, 2012Co-Authors: Nancy E Kemeny, Peter J. Allen, Philip Paty, Yuman Fong, William R. Jarnagin, Ronald P. Dematteo, Mithat Gonen, Michael I DangelicaAbstract:Background Hepatic arterial infusion pump chemotherapy (HAIPC) contributes to the prolonged survival of selected patients with colorectal cancer liver metastases (CRCLM). The most clinically important adverse event after HAIPC with Floxuridine (FUDR) is biliary sclerosis (BS). Little is known about the etiology of BS.
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treating primary liver cancer with hepatic arterial infusion of Floxuridine and dexamethasone does the addition of systemic bevacizumab improve results
Oncology, 2011Co-Authors: Nancy E Kemeny, Alexandra N. Gewirtz, David H Gultekin, Dana Haviland, Adam C. Yopp, Yuman Fong, Michael I Dangelica, Lawrence H Schwartz, Mithat Gonen, Peter J. AllenAbstract:Objectives: This study investigated the efficacy and safety of adding systemic (IV) bevacizumab (Bev) to hepatic arterial infusion (HAI) with Floxuridine (FUDR)/dexamethasone (Dex)
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antiangiogenic therapy for primary liver cancer correlation of changes in dynamic contrast enhanced magnetic resonance imaging with tissue hypoxia markers and clinical response
Annals of Surgical Oncology, 2011Co-Authors: Adam C. Yopp, David H Gultekin, Dana Haviland, Nancy E Kemeny, Michael I Dangelica, Lawrence H Schwartz, Mithat Gonen, Zubin M Bamboat, Jinru Shia, Yuman FongAbstract:Background This study utilized the imaging data of primary liver cancer (PLC) treated with Floxuridine (FUDR) and bevacizumab to test the hypothesis that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters correlate with tissue hypoxia markers and treatment outcome.
Yasuhiro Tsume - One of the best experts on this subject based on the ideXlab platform.
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the dipeptide monoester prodrugs of Floxuridine and gemcitabine feasibility of orally administrable nucleoside analogs
Pharmaceuticals, 2014Co-Authors: Yasuhiro Tsume, Blanca Borras Bermejo, Gordon L. AmidonAbstract:Dipeptide monoester prodrugs of Floxuridine and gemcitabine were synthesized. Their chemical stability in buffers, enzymatic stability in cell homogenates, permeability in mouse intestinal membrane along with drug concentration in mouse plasma, and anti-proliferative activity in cancer cells were determined and compared to their parent drugs. Floxuridine prodrug was more enzymatically stable than Floxuridine and the degradation from prodrug to parent drug works as the rate-limiting step. On the other hand, gemcitabine prodrug was less enzymatically stable than gemcitabine. Those dipeptide monoester prodrugs exhibited 2.4- to 48.7-fold higher uptake than their parent drugs in Caco-2, Panc-1, and AsPC-1 cells. Floxuridine and gemcitabine prodrugs showed superior permeability in mouse jejunum to their parent drugs and exhibited the higher drug concentration in plasma after in situ mouse perfusion. Cell proliferation assays in ductal pancreatic cancer cells, AsPC-1 and Panc-1, indicated that dipeptide prodrugs of Floxuridine and gemcitabine were more potent than their parent drugs. The enhanced potency of nucleoside analogs was attributed to their improved membrane permeability. The prodrug forms of 5¢-L-phenylalanyl-l-tyrosyl-Floxuridine and 5¢-L-phenylalanyl-L-tyrosyl-gemcitabine appeared in mouse plasma after the permeation of intestinal membrane and the first-pass effect, suggesting their potential for the development of oral dosage form for anti-cancer agents.
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The Dipeptide Monoester Prodrugs of Floxuridine and Gemcitabine—Feasibility of Orally Administrable Nucleoside Analogs
MDPI AG, 2014Co-Authors: Yasuhiro Tsume, Blanca Borras Bermejo, Gordon L. AmidonAbstract:Dipeptide monoester prodrugs of Floxuridine and gemcitabine were synthesized. Their chemical stability in buffers, enzymatic stability in cell homogenates, permeability in mouse intestinal membrane along with drug concentration in mouse plasma, and anti-proliferative activity in cancer cells were determined and compared to their parent drugs. Floxuridine prodrug was more enzymatically stable than Floxuridine and the degradation from prodrug to parent drug works as the rate-limiting step. On the other hand, gemcitabine prodrug was less enzymatically stable than gemcitabine. Those dipeptide monoester prodrugs exhibited 2.4- to 48.7-fold higher uptake than their parent drugs in Caco-2, Panc-1, and AsPC-1 cells. Floxuridine and gemcitabine prodrugs showed superior permeability in mouse jejunum to their parent drugs and exhibited the higher drug concentration in plasma after in situ mouse perfusion. Cell proliferation assays in ductal pancreatic cancer cells, AsPC-1 and Panc-1, indicated that dipeptide prodrugs of Floxuridine and gemcitabine were more potent than their parent drugs. The enhanced potency of nucleoside analogs was attributed to their improved membrane permeability. The prodrug forms of 5¢-L-phenylalanyl-l-tyrosyl-Floxuridine and 5¢-L-phenylalanyl-L-tyrosyl-gemcitabine appeared in mouse plasma after the permeation of intestinal membrane and the first-pass effect, suggesting their potential for the development of oral dosage form for anti-cancer agents
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the feasibility of enzyme targeted activation for amino acid dipeptide monoester prodrugs of Floxuridine cathepsin d as a potential targeted enzyme
Molecules, 2012Co-Authors: Yasuhiro Tsume, Gordon L. AmidonAbstract:The improvement of therapeutic efficacy for cancer agents has been a big challenge which includes the increase of tumor selectivity and the reduction of adverse effects at non-tumor sites. In order to achieve those goals, prodrug approaches have been extensively investigated. In this report, the potential activation enzymes for 5¢-amino acid/dipeptide monoester Floxuridine prodrugs in pancreatic cancer cells were selected and the feasibility of enzyme specific activation of prodrugs was evaluated. All prodrugs exhibited the range of 3.0–105.7 min of half life in Capan-2 cell homogenate with the presence and the absence of selective enzyme inhibitors. 5¢-O-L-Phenylalanyl-L-tyrosyl-Floxuridine exhibited longer half life only with the presence of pepstatin A. Human cathepsin B and D selectively hydrolized 5¢-O-L-phenylalanyl-L-tyrosylFloxuridine and 5¢-O-L-phenylalanyl-L-glycylFloxuridine compared to the other tested prodrugs. The wide range of growth inhibitory effect by Floxuridine prodrugs in Capan-2 cells was observed due to the different affinities of prodrug promoieties to enyzmes. In conclusion, it is feasible to design prodrugs which are activated by specific enzymes. Cathepsin D might be a good candidate as a target enzyme for prodrug activation and 5¢-O-L-phenylalanyl-L-tyrosylFloxuridine may be the best candidate among the tested Floxuridine prodrugs.
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The Feasibility of Enzyme Targeted Activation for Amino Acid/Dipeptide Monoester Prodrugs of Floxuridine; Cathepsin D as a Potential Targeted Enzyme
MDPI AG, 2012Co-Authors: Gordon L. Amidon, Yasuhiro TsumeAbstract:The improvement of therapeutic efficacy for cancer agents has been a big challenge which includes the increase of tumor selectivity and the reduction of adverse effects at non-tumor sites. In order to achieve those goals, prodrug approaches have been extensively investigated. In this report, the potential activation enzymes for 5¢-amino acid/dipeptide monoester Floxuridine prodrugs in pancreatic cancer cells were selected and the feasibility of enzyme specific activation of prodrugs was evaluated. All prodrugs exhibited the range of 3.0–105.7 min of half life in Capan-2 cell homogenate with the presence and the absence of selective enzyme inhibitors. 5¢-O-L-Phenylalanyl-L-tyrosyl-Floxuridine exhibited longer half life only with the presence of pepstatin A. Human cathepsin B and D selectively hydrolized 5¢-O-L-phenylalanyl-L-tyrosylFloxuridine and 5¢-O-L-phenylalanyl-L-glycylFloxuridine compared to the other tested prodrugs. The wide range of growth inhibitory effect by Floxuridine prodrugs in Capan-2 cells was observed due to the different affinities of prodrug promoieties to enyzmes. In conclusion, it is feasible to design prodrugs which are activated by specific enzymes. Cathepsin D might be a good candidate as a target enzyme for prodrug activation and 5¢-O-L-phenylalanyl-L-tyrosylFloxuridine may be the best candidate among the tested Floxuridine prodrugs
-
potential of amino acid dipeptide monoester prodrugs of Floxuridine in facilitating enhanced delivery of active drug to interior sites of tumors a two tier monolayer in vitro study
Pharmaceutical Research, 2011Co-Authors: Yasuhiro Tsume, John M. Hilfinger, Gordon L. AmidonAbstract:Purpose To evaluate the advantages of amino acid/dipeptide monoester prodrugs for cancer treatments by assessing the uptake and cytotoxic effects of Floxuridine prodrugs in a secondary cancer cell monolayer following permeation across a primary cancer cell monolayer.
Mithat Gonen - One of the best experts on this subject based on the ideXlab platform.
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regional chemotherapy for unresectable intrahepatic cholangiocarcinoma a potential role for dynamic magnetic resonance imaging as an imaging biomarker and a survival update from two prospective clinical trials
Annals of Surgical Oncology, 2014Co-Authors: Ioannis Konstantinidis, David H Gultekin, Peter J. Allen, Yuman Fong, Ronald P. Dematteo, Michael I Dangelica, Lawrence H Schwartz, Mithat Gonen, David S Klimstra, Nancy E KemenyAbstract:Background For patients with unresectable intrahepatic cholangiocarcinoma (ICC), treatment options are limited and survival is poor. This study summarizes the long-term outcome of two previously reported clinical trials using hepatic arterial infusion (HAI) with Floxuridine and dexamethasone (with or without bevacizumab) in advanced ICC.
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biliary sclerosis after hepatic arterial infusion pump chemotherapy for patients with colorectal cancer liver metastasis incidence clinical features and risk factors
Annals of Surgical Oncology, 2012Co-Authors: Nancy E Kemeny, Peter J. Allen, Philip Paty, Yuman Fong, William R. Jarnagin, Ronald P. Dematteo, Mithat Gonen, Michael I DangelicaAbstract:Background Hepatic arterial infusion pump chemotherapy (HAIPC) contributes to the prolonged survival of selected patients with colorectal cancer liver metastases (CRCLM). The most clinically important adverse event after HAIPC with Floxuridine (FUDR) is biliary sclerosis (BS). Little is known about the etiology of BS.
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treating primary liver cancer with hepatic arterial infusion of Floxuridine and dexamethasone does the addition of systemic bevacizumab improve results
Oncology, 2011Co-Authors: Nancy E Kemeny, Alexandra N. Gewirtz, David H Gultekin, Dana Haviland, Adam C. Yopp, Yuman Fong, Michael I Dangelica, Lawrence H Schwartz, Mithat Gonen, Peter J. AllenAbstract:Objectives: This study investigated the efficacy and safety of adding systemic (IV) bevacizumab (Bev) to hepatic arterial infusion (HAI) with Floxuridine (FUDR)/dexamethasone (Dex)
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antiangiogenic therapy for primary liver cancer correlation of changes in dynamic contrast enhanced magnetic resonance imaging with tissue hypoxia markers and clinical response
Annals of Surgical Oncology, 2011Co-Authors: Adam C. Yopp, David H Gultekin, Dana Haviland, Nancy E Kemeny, Michael I Dangelica, Lawrence H Schwartz, Mithat Gonen, Zubin M Bamboat, Jinru Shia, Yuman FongAbstract:Background This study utilized the imaging data of primary liver cancer (PLC) treated with Floxuridine (FUDR) and bevacizumab to test the hypothesis that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters correlate with tissue hypoxia markers and treatment outcome.
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incidence and risk factors for biliary sclerosis following adjuvant hepatic arterial infusion with Floxuridine after hepatectomy for metastatic colorectal cancer
Journal of Clinical Oncology, 2010Co-Authors: K Ito, Peter J. Allen, Nancy E Kemeny, Yuman Fong, Mithat Gonen, Hiromichi Ito, R P Dematteo, Leslie H Blumgart, W R Jarnagin, Michael I DangelicaAbstract:3556 Background: Adjuvant hepatic arterial infusion pump chemotherapy (HAIPC) with Floxuridine (FUDR) contributes to the prolonged progression-free survival of patients with resected colorectal can...