International Atomic Energy Agency-Sponsored Multination Study of Intra-Arterial Rhenium-188-Labeled Lipiodol in the Treatment of Inoperable Hepatocellular Carcinoma: Results With Special Emphasis on Prognostic Value of Dosimetric Study

Bernal, Patricia; Raoul, Jean‐Luc; Stare, Janez; Sereegotov, Erdenechimeg; Sundram, F. X.; Kumar, Ajay; Jeong, Jae Min; Pusuwan, Pawana; Divgi, Chaitanya; Zanzonico, Pat; Vidmar, Gaj; Buscombe, J. R.; Chau, Trinh Thi Minh; Saw, Maung Maung; Chen, Shao‐Liang; Ogbac, Ruben; Dondi, Maurizio; Padhy, Ajit Kumar

doi:10.1053/j.semnuclmed.2007.10.006

Cited by 38 publications

(33 citation statements)

References 13 publications

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“…Also, the advantage of a generator-produced radioisotope is that greater usage leads to lower per-unit cost [21]. In this study, the 188 W generator was held in a central facility and its long half-life (69.8 d) of 188 Re allowed this 1 facility to provide treatment doses to many regional hospitals, as has been done in other trials using 188 Re-HDD Lipiodol [14,15]. This again could improve cost efficiency.…”

Section: Discussionmentioning

confidence: 99%

Initial Study of Radiological and Clinical Efficacy Radioembolization Using 188Re-Human Serum Albumin (HSA) Microspheres in Patients with Progressive, Unresectable Primary or Secondary Liver Cancers

Nowicki

Ćwikła²,

Sankowski

et al. 2014

Med Sci Monit

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BackgroundThe aim of this initial study was to evaluate the clinical and radiological effectiveness of radioembolization (RE) using 188Re-Human Serum Albumin (HSA) microspheres in patients with advanced, progressive, unresectable primary or secondary liver cancers, not suitable to any other form of therapy.Material/MethodsOverall, we included 13 patients with 20 therapy sessions. Clinical and radiological responses were assessed at 6 weeks after therapy, and then every 3 months. The objective radiological response was classified according to Response Evaluation Criteria in Solid Tumors (RECIST) v.1.0 by sequential MRI. Adverse events were evaluated using NCI CTCAE v.4.03.ResultsThere were 4 patients with hepatocellular carcinoma (HCC), 6 with metastatic colorectal cancer (mCRC), 2 with neuroendocrine carcinoma (NEC), and 1 patient with ovarian carcinoma. Mean administered activity of 188Re HSA was 7.24 GBq (range 3.8–12.4) A high microspheres labeling efficacy of over 97±2.1% and low urinary excretion of 188Re (6.5±2.3%) during first 48-h follow-up. Median overall survival (OS) for all patients was 7.1 months (CI 6.2–13.3) and progression-free survival (PFS) was 5.1 months (CI 2.4–9.9). In those patients who had a clinical partial response (PR), stable disease (SD), and disease progression (DP) as assessed 6 weeks after therapy, the median OS was 9/5/4 months, respectively, and PFS was 5/2/0 months, respectively. The treatment adverse events (toxicity) were at an acceptable level. Initially and after 6 weeks, the CTC AE was grade 2, while after 3 months it increased to grade 3 in 4 subjects. This effect was mostly related to rapid cancer progression in this patient subgroup.ConclusionsThe results of this preliminary study indicate that RE using 188Re HSA is feasible and a viable option for palliative therapy in patients with extensive progressive liver cancer. It was well tolerated by most patients, with a low level of toxicity during the 3 months of follow-up.

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Section: Discussionmentioning

confidence: 99%

Initial Study of Radiological and Clinical Efficacy Radioembolization Using 188Re-Human Serum Albumin (HSA) Microspheres in Patients with Progressive, Unresectable Primary or Secondary Liver Cancers

Nowicki

Ćwikła²,

Sankowski

et al. 2014

Med Sci Monit

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“…105 In a study of transarterial rhenium-188-labeled lipiodol in the treatment of unresectable hepatocellular carcinoma, the radiation-absorbed dose in tumor correlated with survival, with patients whose tumors received more than 30 Gy having a significantly longer survival. 106 Given these correlations, it is tempting to use the individual patient pretherapy data to decide the injected activity. However, the tumor dose/response remains loose on an individual basis.…”

Section: Tissue-effect/radiation-dose Relationshipmentioning

confidence: 99%

Review:What Can Be Expected from Nuclear Medicine Tomorrow?

Barbet

Kraeber-Bodéré

Chatal

2008

Cancer Biotherapy and Radiopharmaceuticals

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Imaging can take advantage of developments in "omics" approaches and go from routine individual biomarkers to multiple-scale biomarker profiles. Imaging structural, functional, metabolic, cellular, and molecular changes will be made possible by multimodality hybrid techniques, such as positron emission tomography-magnetic resonance imaging. Imaging should predict treatment response, look at stratification for specific treatment modalities, and look at the "omic" characterization of an individual patient or a specific tumor. This should lead to the development of "personalized" medicine. In cancer radiotherapy, patient responses should be accurately predicted. In specific cases, proton and hadrontherapy will be further enhanced by the irradiation dose delivered to the tumors. For disseminated or metastatic disease, targeted radionuclide therapy is an effective addition to the arsenal against cancer. The clinical efficacy of radiolabeled antibodies has been clearly demonstrated in lymphoma as well as that of radiolabeled peptides derived from somatostatin in the treatment of neuroendocrine tumors. Preliminary studies now show interesting results in solid tumors, too. Even if the number of objective clinical responses based on tumor shrinkage is small, targeted radionuclide therapy increases progression-free survival or overall survival in some specific cases where tumor burden is small. Avenues for further improvement are multiple and include combination with other therapeutic modalities, development of new approaches (e.g., small molecules, pretargeting, and antibody alternatives). Using alpha-emitting radionuclides is another possibility for specific diseases, such as leukemias, multiple myeloma, or brain tumor remnants.

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“…106 The overall survival rate of 46% and 23% at 1 and 2 years has also been shown by another multicentric study. 107 It has also been tried in patients with post-radiofrequency ablation recurrences as well. 108…”

Section: A Indications and Contraindications Of Tartmentioning

confidence: 99%

Role of Transcatheter Intra-arterial Therapies for Hepatocellular Carcinoma

Paul

Sharma

2014

Journal of Clinical and Experimental Hepatology

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Transcatheter intra-arterial therapies play a vital role in treatment of HCC due to the unique tumor vasculature. Evolution of techniques and newer efficacious modalities of tumor destruction have made these techniques popular. Various types of intra-arterial therapeutic options are currently available. These constitute: bland embolization, trans-arterial chemotherapy, trans-arterial chemo embolization with or without drug-eluting beads and trans-arterial radio embolization, which are elaborated in this review.

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International Atomic Energy Agency-Sponsored Multination Study of Intra-Arterial Rhenium-188-Labeled Lipiodol in the Treatment of Inoperable Hepatocellular Carcinoma: Results With Special Emphasis on Prognostic Value of Dosimetric Study

Cited by 38 publications

References 13 publications

Initial Study of Radiological and Clinical Efficacy Radioembolization Using 188Re-Human Serum Albumin (HSA) Microspheres in Patients with Progressive, Unresectable Primary or Secondary Liver Cancers

Initial Study of Radiological and Clinical Efficacy Radioembolization Using 188Re-Human Serum Albumin (HSA) Microspheres in Patients with Progressive, Unresectable Primary or Secondary Liver Cancers

Review:What Can Be Expected from Nuclear Medicine Tomorrow?

Role of Transcatheter Intra-arterial Therapies for Hepatocellular Carcinoma

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