Glass Microspheres 90Y Selective Internal Radiation Therapy and Chemotherapy as First-Line Treatment of Intrahepatic Cholangiocarcinoma

Edeline, Julien; Du, Fanny Le; Rayar, Michel; Rolland, Yan; Beuzit, Luc; Boudjéma, Karim; Rohou, Tanguy; Latournerie, Marianne; Campillo‐Gimenez, Boris; Garin, Étienne; Boucher, Éveline

doi:10.1097/rlu.0000000000000904

Cited by 57 publications

(55 citation statements)

References 19 publications

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“…For these patients, palliative treatment, usually in the form of systemic chemotherapy, is the only option of treatment. Selected patients with liver-predominant disease may benefit from liver-directed therapies such as external beam radiation (24, 25) or radioembolization (26, 27). Unfortunately, data suggesting such benefit is based on retrospective series or small phase II trials rather than randomized studies; further data are awaited to confirm the incremental benefit of approaches involving liver radioembolization.…”

Section: Clinical Contextmentioning

confidence: 99%

New Horizons for Precision Medicine in Biliary Tract Cancers

et al. 2017

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Biliary tract cancers (BTCs), including cholangiocarcinoma and gallbladder cancer, are poor-prognosis and low-incidence cancers, although the incidence of intrahepatic cholangiocarcinoma is rising. A minority of patients presents with resectable disease; however, relapse rates are high; benefit from adjuvant capecitabine chemotherapy has been suggested. Cisplatin/gemcitabine combination chemotherapy has emerged as the reference first-line treatment regimen; there is no standard second-line therapy. Selected patients may be suitable for liver-directed therapy (e.g. radioembolization or external beam radiation); pending confirmation of benefit in randomized studies. Initial trials targeting the epithelial growth factor receptor and angiogenesis pathways have failed to deliver new treatments. Emerging data from next generation sequencing analyses have identified actionable mutations (e.g. FGFR fusion rearrangements and IDH-1 and -2 mutations) with several targeted drugs entering clinical development with encouraging results. The role of systemic therapies, including targeted therapies and immunotherapy for BTC is rapidly evolving and the subject of this review.

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Section: Clinical Contextmentioning

confidence: 99%

New Horizons for Precision Medicine in Biliary Tract Cancers

et al. 2017

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“…A total of 166 articles were identified using our search criteria for screening (Figure ). Following assessment by the adopted exclusion criteria, 12 studies were identified after thorough assessment of the full manuscripts . Of these, two were excluded because they were subsequently updated and one because it duplicated another more complete report .…”

Section: Resultsmentioning

confidence: 99%

Improving patient selection for selective internal radiation therapy of intra‐hepatic cholangiocarcinoma: A meta‐regression study

Cucchetti

Cappelli

Mosconi

et al. 2017

Liver International

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“…Its interest in the palliative treatment of ICC has been demonstrated [7,18,19] and our team recently reported its utility for downstaging huge initially unresectable lesions, thereby enabling secondary resection [8].…”

Section: Discussionmentioning

confidence: 99%

“…Radioembolization with Yttrium-90 (Ytt-90) is a promising method that has already demonstrated its efficacy as a palliative treatment for HCC or ICC, and is an effective therapy for downstaging to resection or LT for HCC [6,7]. Recently, we showed its interest in downstaging huge and unresectable ICCs which enabled secondary resection [8].…”

Section: Introductionmentioning

confidence: 99%

Multimodal Therapy including Yttrium-90 Radioembolization as a Bridging Therapy to Liver Transplantation for a Huge and Locally Advanced Intrahepatic Cholangiocarcinoma

Rayar

Sandri

Houssel‐Debry

et al. 2016

JGLD

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Treatment of intrahepatic cholangiocarcinoma remains a major challenge. For an unresectable lesion without extrahepatic spread, liver transplantation could be a potential solution but it is still associated with poor oncologic results owing to the absence of effective neoadjuvant treatment. We report the case of a young man with locally advanced intrahepatic cholangiocarcinoma presenting with multiple intrahepatic metastases and vascular structure involvement. The lesion was significantly downstaged by a multimodal therapy including intra-arterial Yttrium-90 radioembolization, systemic chemotherapy and external radiotherapy, allowing liver transplantation. Three years after the procedure, oncologic outcome is excellent with no sign of recurrence.Multimodal therapy including Yttrium-90 radioembolization could be relevant as neoadjuvant treatment before liver transplantation for unresectable intrahepatic cholangiocarcinoma. Abbrevations: CA 19-9: carbohydrate antigen 19-9; FDG-PET: fluorodeoxyglucose positron emission tomography; HCC: hepatocellular carcinoma; ICC: intrahepatic cholangiocarcinoma; LT: liver transplantation; MRI: magnetic resonance imaging; PHC: perihilar cholangiocarcinoma; Ytt-90: Yttrium-90.

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Glass Microspheres 90Y Selective Internal Radiation Therapy and Chemotherapy as First-Line Treatment of Intrahepatic Cholangiocarcinoma

Abstract: Selective internal radiation therapy combined with concomitant chemotherapy seems a promising strategy as first-line treatment for unresectable intrahepatic cholangiocarcinoma.

Cited by 57 publications

References 19 publications

New Horizons for Precision Medicine in Biliary Tract Cancers

New Horizons for Precision Medicine in Biliary Tract Cancers

Improving patient selection for selective internal radiation therapy of intra‐hepatic cholangiocarcinoma: A meta‐regression study

Multimodal Therapy including Yttrium-90 Radioembolization as a Bridging Therapy to Liver Transplantation for a Huge and Locally Advanced Intrahepatic Cholangiocarcinoma

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