Change in total lesion glycolysis and clinical outcome after 90Y radioembolization in intrahepatic cholangiocarcinoma

Filippi, Luca; Pelle, Giuseppe; Cianni, Roberto; Scopinaro, Francesco; Bagni, Oreste

doi:10.1016/j.nucmedbio.2014.08.011

Cited by 39 publications

(36 citation statements)

References 23 publications

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“…PR was achieved in 14 patients (82.3%) and SD in three patients (17.6%). Similar to the aforementioned trial, imaging-based response evaluation corresponded well with the mean OS being 18.2 and 9.9 months for responders (SUV decrease ≥50%) and nonresponders, respectively (52).…”

Section: Y90-re-clinical Evidencesupporting

confidence: 63%

Intra-arterial embolotherapy for intrahepatic cholangiocarcinoma: update and future prospects

Savic¹,

Chapiro²,

Geschwind³

2017

Hepatobiliary Surg. Nutr.

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Intrahepatic cholangiocarcinoma (ICC) is a rare disease and carries a poor prognosis with surgery remaining the only curative treatment option. However, due to the late presentation of symptoms and close proximity of the tumors to central hepatic structures, only about 30% of patients are classified eligible to resection. As for palliative approaches, ICC constitutes a possible indication for loco-regional therapies (LRT). As such, intra-arterial therapies (IAT) are reported to be feasible, safe and effective in inducing tumor response in unresectable ICC. The paradigm of IAT is premised on the selective delivery of embolic, chemotherapeutic agents to the tumor via its feeding arteries, thus allowing dose escalation within the carcinoma and reduction of systemic toxicity. Conventional transcatheter arterial chemoembolization (cTACE) so far remains the most commonly used IAT modality. However, drug-eluting beads (DEB)-TACE was initiated with the idea of more selective targeting of the tumor owing to the combined embolizing as well as drug-eluting properties of the microspheres used in this setting. Moreover, radioembolization is performed by intra-arterial administration of very small spheres containing β-emitting yttrium-90 (Y90-RE) to the site of the tumor. Clinical evidence exists in support of survival benefits for IAT in the palliative treatment of ICC compared to surgery and systemic chemotherapy. As for combination regimens, cTACE, DEB-TACE and Y90-RE are reported to achieve conversion of patients to surgery in a sequential treatment planning and simultaneous IAT combinations may provide a therapeutic option for treatment escalation. Regarding the current status of literature, controlled randomized prospective trials to compare different IAT techniques and combination therapies as well as treatment recommendations for different IAT modalities are needed.

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Section: Y90-re-clinical Evidencesupporting

confidence: 63%

Intra-arterial embolotherapy for intrahepatic cholangiocarcinoma: update and future prospects

Savic¹,

Chapiro²,

Geschwind³

2017

Hepatobiliary Surg. Nutr.

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“…The median survival for patients with 4-week post-treatment TLG values of above and below 100 g were 10.9 and 26.9 months, respectively. These results have been recently confirmed: the decrease in TLG (ΔTLG), measured 6 weeks after 90 Y RE, has been demonstrated to strictly agree with clinical outcome of patients affected by intrahepatic cholangiocarcinoma [21].…”

mentioning

confidence: 56%

18F-FDG PET-derived parameters as prognostic indices in hepatic malignancies after 90Y radioembolization: is there a role?

Bagni

Filippi

Schillaci

2014

Eur J Nucl Med Mol Imaging

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“…Several prospective and retrospective studies have assessed SIRT in ICC (all second-or later-line), which demonstrate median OS of between 9.3 and 22 months (19,(92)(93)(94)(95)(96)(97)(98)(99)(100). A pooled analysis of 12 studies, with a total of 298 patients with unresectable ICC treated with SIRT, demonstrated a median OS of 15.5 months and treatment response rate of 28% (101).…”

Section: Iccmentioning

confidence: 99%

Safety of selective internal radiation therapy (SIRT) with yttrium-90 microspheres combined with systemic anticancer agents: expert consensus

Kennedy

Brown

Feilchenfeldt

et al. 2017

J. Gastrointest. Oncol.

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Selective internal radiation therapy (SIRT) with microspheres labelled with the β-emitter yttrium-90 (Y-90) enables targeted delivery of radiation to hepatic tumors. SIRT is primarily used to treat inoperable primary or metastatic liver tumors. Eligible patients have usually been exposed to a variety of systemic anticancer therapies, including cytotoxic agents, targeted biologics, immunotherapy and peptide receptor radionuclide therapy (PRRT). All these treatments have potential interactions with SIRT; however, robust evidence on the safety of these potential combinations is lacking. This paper provides current clinical experiences and expert consensus guidelines for the use of SIRT in combination with the anticancer treatment agents likely to be encountered in clinical practice. It was agreed by the expert panel that precautions need to be taken with certain drugs, but that, in general, systemic therapies do not necessarily have to be stopped to perform SIRT. The authors recommend stopping vascular endothelial growth factor inhibitors 4-6 weeks before SIRT, and restart after the patient has recovered from the procedure. It may also be prudent to stop potent radiosensitizers such as gemcitabine therapy 4 weeks before SIRT, and restart treatment at least 2-4 weeks later. Data from phase III studies combining SIRT with fluorouracil (5FU) or folinic acid/5FU/oxaliplatin (FOLFOX) suggest that hematological toxicity is more common from the combination than it is from chemotherapy without SIRT. There is no evidence to suggest that chemotherapy increases SIRT-specific gastro-intestinal or liver toxicities.

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Change in total lesion glycolysis and clinical outcome after 90Y radioembolization in intrahepatic cholangiocarcinoma

Cited by 39 publications

References 23 publications

Intra-arterial embolotherapy for intrahepatic cholangiocarcinoma: update and future prospects

Intra-arterial embolotherapy for intrahepatic cholangiocarcinoma: update and future prospects

18F-FDG PET-derived parameters as prognostic indices in hepatic malignancies after 90Y radioembolization: is there a role?

Safety of selective internal radiation therapy (SIRT) with yttrium-90 microspheres combined with systemic anticancer agents: expert consensus

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