INCLUSION CRITERIA:
1. Patients must be equal to or greater than 16 years of age.
2. Histologically or cytologically proven cancer, predominantly in the parenchyma of the liver with one of the following histologies: adenocarcinoma, neuroendocrine tumor or primary hepatic malignancy. Evidence of limited unresectable extrahepatic disease on preoperative radiological studies is acceptable if the life-limiting component of progressive disease is in liver. Examples of limited extrahepatic disease that may be commonly encountered and considered acceptable include, but are not necessarily limited to up to four pulmonary nodules each less than 1 cm in diameter, retroperitoneal lymph nodes less than 3 cm in diameter, skin or subcutaneous metastases that are fewer than 10 in number and less than 1 cm in diameter, asymptomatic bone metastases that have been or can be palliated with external beam radiation therapy, or a solitary metastasis to any site that can be resected. For patients with hepatic metastases from colorectal tumors, patients must have been treated with first and second line chemotherapy (including CPT-11 and oxaliplatin) prior to being treated on this phase II trial.
3. Patients previously treated with IHP (with or without hepatic arterial infusion using FUDR) or PHP will be eligible if they had a radiographic partial response of 3 months duration to the therapy.
4. Patients must have had no chemotherapy, radiotherapy, or biologic therapy for their malignancy in the month prior to treatment and must have recovered from all side effects, except those listed in Appendix I.
5. Patients must have an ECOG performance standard of less than 3 at on study and on the day prior to treatment.
6. Patients must have adequate hepatic function as evidence by a total serum bilirubin less than or equal to 2.0 mg/dL and a PT within 2 seconds of the upper normal limit. AST/ALT must be less than or equal to 10 times upper limit of normal.
7. NCI Laboratory of Pathology will confirm Pathology
8. Patients must be aware of the neoplastic nature of his/her illness, the experimental nature of the therapy, alternative treatments, potential benefits, and risks. The patient must be willing to sign an informed consent.
EXCLUSION CRITERIA:
1. Patients with Childs B or C cirrhosis or with evidence of portal hypertension by history, endoscopy, or radiologic studies will be excluded.
2. Patients with a history of congestive heart failure with an LVEF less than 40% will be excluded.
3. Patients with COPD or other chronic pulmonary disease with PFT's indicating an FEV1 less than 30% or a DLCO less than 40% predicted for age will be excluded.
4. Patients must be greater than 35 kg because of size limitations with respect to percutaneous catheterization of the femoral artery and vein using this system.
5. Patients must have a platelet count greater than or equal to 75,000/mm(3), a Hct greater than 27.0, an ANC greater than or equal to 1.3 microL and a creatinine less than or equal to 1.5 mg/dL unless the measured creatinine clearance is greater than 60mL/min/1.73m(2).
6. Pregnant patients and nursing mothers will be excluded because of the unknown effects of this therapy on the fetus or nursing mothers.
7. Patients taking immunosuppressive drugs or requiring ongoing chronic anticoagulation will not be eligible.
8. Patients with active infections are not eligible.
9. Patients with severe allergic reactions to iodine contrast which can not be controlled by premedication with antihistamines and steroids are not eligible as a hepatic angiogram is needed for this procedure.
10. Patients with a known prior hypersensitivity reaction to melphalan will be excluded.
11. Patients with resectable tumor(s) of the liver will be excluded.
Warren Grant Magnuson Clinical Center (CC)