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RFP7. IL-13 levels are elevated in floxuridine-treated patient plasma and ex vivo cystic duct perfusates

Friday, March 6, 2026
4:59 PM - 5:06 PM MST
Location: 106A-C
Introduction: Hepatic artery infusion pump floxuridine is an increasingly employed management strategy for patients with liver-limited colorectal liver metastases. However, floxuridine results in biliary injury, which limits the amount of drug administered and thereby its efficacy in order to avoid biliary sclerosis. To mitigate the injury, dexamethasone (a potent immunosuppressant) is administered concomitantly with floxuridine, although the immune pathways activated by the injury are unstudied.

Methods: Serum samples were collected from 9 patients undergoing hepatic artery infusion pump therapy at baseline and following two weeks of floxuridine/dexamethasone treatment (no systemic therapy). Autologous plasma perfusate was collected following 96 hours of ex vivo perfusion of cystic ducts (n=2) treated with floxuridine. All samples were evaluated with the Olink Target 96 Immuno-Oncology panel.

Results: Following 96 hours of floxuridine treatment, a significant increase (≥100% change) in IL-13 levels was observed in perfusate of ex vivo cystic duct compared to control perfusates. IL-10 demonstrated similar elevation (≥100% change). Correlation with patient serum demonstrated significant elevation of IL-13 levels following two weeks of floxuridine/dexamethasone treatment and significantly decreased levels of IL-6. Further investigation demonstrated no correlation of IL-13 levels with liver function test levels (alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, direct and total bilirubin) during this time frame.

Conclusions: Our data suggests that IL-13, a well-established promoter of hepatic fibrosis, may play a role in biliary injury following long-term (multiple cycles) floxuridine treatment. Further investigation of IL-13 throughout the treatment course may aid in the development of mitigating therapies.

Learning Objectives:

  • Participants should understand that IL-13 levels are elevated in patient plasma following two weeks of floxuridine/dexamethasone treatment.
  • Participants should understand that levels of IL-13 are elevated in serum perfusates of ex vivo cystic duct tissue after 96-hour floxuridine treatment.
  • Participants should consider that IL-13 may play a key role in development of inflammation and biliary sclerosis after multiple cycles of floxuridine treatment.