Isolated Hepatic Perfusion With Melphalan in Treating Patients With Unresectable Colorectal Cancer That Has Metastasized to the Liver

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed colorectal cancer
• Metastatic disease limited to the parenchyma of the liver
• Patients with limited sites of extrahepatic disease AND who have dominant life-limiting disease in the liver are considered eligible provided the extrahepatic sites can be treated with local ablative measures (e.g., resection or external beam radiotherapy)
• No other evidence of unresectable extrahepatic disease by radiological studies
• Unresectable hepatic disease defined by > 3 sites of disease in the liver, bilobar disease, or tumor abutting major vascular or ductal structures making anatomic resection with liver function preservation impossible
• Measurable disease
• Refractory to prior first-line systemic chemotherapy
• Disease progression during or after completion of treatment with an irinotecan- or oxaliplatin-containing regimen for established hepatic metastases
• Treatment failure is defined as disease progression evidenced by tumor growth OR new lesions on imaging modalities OR increasing carcinoembryonic antigen (CEA)

PATIENT CHARACTERISTICS:

Age

• 18 and over

Performance status

• ECOG 0-2

Life expectancy

• Not specified

Hematopoietic

• Hematocrit > 27.0%
• Platelet count > 100,000/mm^3
• WBC > 3,000/mm^3

Hepatic

• Bilirubin < 2.0 mg/dL
• PT ≤ 2 seconds of the upper limit of normal
• ALT and AST elevations secondary to metastatic disease allowed
• Chronic active hepatitis B or C allowed provided there is no evidence of cirrhosis on pathology, radiologic studies, or physical exam
• No history of veno-occlusive disease
• No biopsy proven cirrhosis
• No evidence of significant portal hypertension manifested by ascites, esophageal varices on endoscopy, or radiologic studies showing significant collateral vessels around the organs drained by the portal venous system
• No other liver condition that would preclude study therapy

Renal

• Creatinine ≤ 1.5 mg/dL OR
• Creatinine clearance > 60 mL/min

Cardiovascular

• LVEF ≥ 40%
• No ischemic cardiac disease
• No history of congestive heart failure

Pulmonary

• Chronic obstructive pulmonary disease or other chronic pulmonary disease allowed provided pulmonary function test ≥ 50% of predicted

Other

• Not pregnant or nursing
• Negative pregnancy test
• No active infection
• Weight > 30 kg

PRIOR CONCURRENT THERAPY:

Biologic therapy

• More than 4 weeks since prior biologic therapy for the malignancy and recovered

Chemotherapy

• See Disease Characteristics
• More than 4 weeks since prior chemotherapy for the malignancy and recovered

Endocrine therapy

• Not specified

Radiotherapy

• See Disease Characteristics
• More than 4 weeks since prior radiotherapy for the malignancy and recovered

Surgery

• See Disease Characteristics

Other

• No concurrent immunosuppressive drugs
• No concurrent chronic anticoagulation therapy