Hepatic Artery Infusion Pump Chemotherapy With Floxuridine and Dexamethasone in Combination With Systemic Chemotherapy for Patients With Colorectal Cancer Metastatic to the Liver

Background: * Nearly 60% of patients with colorectal cancers will develop liver metastases over the course of their disease. * Of patients with metastatic colorectal cancer, the liver will be the sole site of recurrence or the survival-limiting site of disease for 20%. * Liver directed therapy, which has taken many forms over the last several decades, is a potential means to prolong survival for properly selected patients and delay progression at that site. * Hepatic artery infusion of floxuridine (FUDR) via an implantable hepatic artery infusion pump (HAIP) induces objective clinical response rates of nearly 50% in heavily pre-treated patients with metastatic colorectal cancer to the liver. * The identification of patients likely to respond to HAIP and those likely to suffer pumprelated adverse events is currently unknown, and has limited the wide-spread adoption of this otherwise well tolerated intervention. Objective: * To assess the safety of hepatic artery infusion therapy using the Medtronic pump with the Codman catheter. * To determine the response rate in patients with unresectable metastatic colorectal cancer treated with HAIP chemotherapy as measured by the Response Evaluation Criteria in Solid Tumors (RECIST). Eligibility: * Histologically or cytologically confirmed colorectal adenocarcinoma metastatic to the liver. * Patients with liver metastases not amenable to resection to No Evidence of Disease (NED) in one stage. * Patients must have received systemic chemotherapy. * Age greater than or equal to 18 years. Design: \- Single arm, Phase II study of HAIP chemotherapy.