Long-Term Toxicity after Transarterial Radioembolization with Yttrium-90 Using Resin Microspheres for Neuroendocrine Tumor Liver Metastases

Tomozawa, Yuki; Jahangiri, Younes; Pathak, Priya; Kolbeck, Kenneth J.; Schenning, Ryan C.; Kaufman, John A.; Farsad, Khashayar

doi:10.1016/j.jvir.2018.02.002

Cited by 62 publications

(57 citation statements)

References 31 publications

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“…Tomozawa et al followed 52 patients for >1 year treated with SIRT for hepatic metastases from NETs and discovered 15 patients with cirrhosis-like morphology on imaging. 118 Similar to the study by Su et al, this was more common in bilobar treatments, with significantly elevated liver function tests and thrombocytopenia in this subcohort, sustained >4 years after treatment. No significant difference was found in predicting OS between unilobar and bilobar treatments (p ¼ 0.676).…”

Section: Gastroenteropancreatic Neuroendocrine Tumor Liver Metastasessupporting

confidence: 84%

Embolotherapy for Hepatic Oncology: Current Perspectives and Future Directions

Bajwa

Madoff

Kishore

2020

Digestive Disease Interventions

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Primary and secondary liver cancers are a major cause of mortality worldwide. Transarterial liver-directed therapy, or embolotherapy, represents an important locoregional treatment strategy for primary and secondary liver tumors. Embolotherapeutic modalities include bland embolization (transarterial embolization), chemoembolization (transarterial chemoembolization), and radioembolization or selective internal radiotherapy. A brief technical overview of embolotherapeutic modalities as well as supportive evidence for the treatment of most common primary and secondary liver tumors will be discussed in this review. Several potential future applications, including synergy with systemic therapy, interventional theranostics, and artificial intelligence will also be reviewed briefly.

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Section: Gastroenteropancreatic Neuroendocrine Tumor Liver Metastasessupporting

confidence: 84%

Embolotherapy for Hepatic Oncology: Current Perspectives and Future Directions

Bajwa

Madoff

Kishore

2020

Digestive Disease Interventions

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“…However, a meta-analysis showed similar survival after TACE and radioembolization [3]. Radioembolization of NET is associated with long term liver toxicity [4]. TACE using drugeluting beads is associated with a high rate of biliary complications [5].…”

Section: Introductionmentioning

confidence: 99%

Outcomes After Transarterial Embolization of Neuroendocrine Tumor Liver Metastases Using Spherical Particles of Different Sizes

Zener

Yoon

Ziv

et al. 2019

Cardiovasc Intervent Radiol

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Purpose: To evaluate initial response and overall survival (OS) of neuroendocrine tumor (NET) liver metastases initially treated with transarterial embolization (TAE) using spherical particles of different sizes. Methods: A single-institution retrospective review was performed of 160 patients with NET liver metastases initially treated with TAE using < 100 μm (n=77) or only ≥ 100 μm (n=83) spherical particles. For each patient, we evaluated: initial response by mRECIST, time to progression, overall survival, complications, primary site, tumor grade and degree of differentiation, volume of liver disease, extrahepatic disease, NET-related symptoms, comorbidities, Child Pugh score, performance status, lobar versus selective embolization, and arteriovenous shunting. Results: Initial response was higher for TAE using particles <100 μm versus TAE using only particles ≥100 μm (64% vs 42%, p=0.007). Multivariate logistic regression showed that use of * Corresponding author. Conflict of interest: FEB is a co-founder of Claripacs, LLC. He received research funding (investigator-initiated) and support for research meetings from Guerbet. He received research support (investigator-initiated) from GE. He received research supplies (investigator-initiated) from Bayer. He received a research grant and speaker fees from Society of Interventional Oncology, which were sponsored by Guerbet. He is an investor in Labdoor, Qventus, CloudMedx, and Notable Labs. Compliance with ethical standards Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required. This HIPAA-compliant retrospective study was approved by the IRB. Informed consent: For this type of study informed consent is not required. This study has obtained IRB approval from Memorial Sloan Kettering Cancer Center and the need for informed consent was waived. Consent for publication: For this type of study consent for publication is not required.

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“…Tomozawa et al found long-term liver toxicity in patients with NET undergoing TARE, including cirrhosis-like morphology and portal hypertension, which was more frequent in patients who received bilobar treatment. 46 Su et al found significantly decreased platelet counts and lower albumin levels in NET patients who had undergone whole liver TARE compared with unilobar TARE. 44 Currie et al found delayed hepatotoxicity in 13% of NET patients treated with TARE, including five deaths attributed to thera-py.…”

Section: Ldt Modalitymentioning

confidence: 99%

Liver-Directed Therapy for Gastroenteropancreatic NETs in the Era of Peptide Receptor Radionuclide Therapy

González-Aguirre

Ziv

2020

Digestive Disease Interventions

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Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) represent a heterogeneous group of tumors. Current treatment algorithms for these tumors are complex and often require a multidisciplinary approach. Recently, peptide receptor radionuclide therapy (PRRT) was granted Food and Drug Administration approval, making this treatment widely available in the United States. PRRT is now another therapeutic option for patients with GEP-NETs. To date there are no consensus guidelines about how to sequence multiple treatment options. Moreover, there is concern of potential liver toxicity when PRRT is used before or after liver-directed therapies (LDTs). In this review, we describe the characteristics of the most commonly used LDT and their potential interactions with PRRT, as well as specific clinical scenarios that are relevant when deciding on the use of LDT. We also review the limited case series that have been published involving patients treated with different combinations of LDT and PRRT. Finally, we discuss some of the future directions for GEP-NET treatments.

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Long-Term Toxicity after Transarterial Radioembolization with Yttrium-90 Using Resin Microspheres for Neuroendocrine Tumor Liver Metastases

Cited by 62 publications

References 31 publications

Embolotherapy for Hepatic Oncology: Current Perspectives and Future Directions

Embolotherapy for Hepatic Oncology: Current Perspectives and Future Directions

Outcomes After Transarterial Embolization of Neuroendocrine Tumor Liver Metastases Using Spherical Particles of Different Sizes

Liver-Directed Therapy for Gastroenteropancreatic NETs in the Era of Peptide Receptor Radionuclide Therapy

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