Prospective randomized pilot study of Y90+/−sorafenib as bridge to transplantation in hepatocellular carcinoma

Kulik, Laura; Vouche, Michaël; Koppe, Sean; Lewandowski, Robert J.; Mulcahy, Mary F.; Ganger, Daniel; Habib, Ali; Karp, J.; Al-Saden, Patrice; Lacouture, Mario E.; Cotliar, Jonathan; Abecassis, Michael; Baker, Talia; Salem, Riad

doi:10.1016/j.jhep.2014.03.023

Cited by 85 publications

(69 citation statements)

References 24 publications

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“…Those reductions and interruptions might suggest that the optimal dose would preferably be lower for patients undergoing this type of combined treatment, because half the patient cohort did not seem to be able to tolerate a full dose of sorafenib. That hypothesis also accords with results of a study by Kulik et al 50 , which prospectively evaluated patients receiving 90 Y with and without sorafenib, and which also pointed toward a sorafenib dose reduction (400 mg daily), because dose reductions were required for all patients in the combined treatment arm. creating a vasculature normalization window 38 .…”

Section: Discussionsupporting

confidence: 86%

Combined Sorafenib and Yttrium-90 Radioembolization for the Treatment of Advanced Hepatocellular Carcinoma

et al. 2016

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Section: Discussionsupporting

confidence: 86%

Combined Sorafenib and Yttrium-90 Radioembolization for the Treatment of Advanced Hepatocellular Carcinoma

et al. 2016

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“…sorafenib) and in BCLC B (TACE/drug-eluting beads ? sorafenib), with the most encouraging results among a HCV alone cohort [16][17][18][19][20]. However, it is apparent that, with tumor progression, many patients develop hepatic decompensation, limiting the ability to initiate sorafenib [21,22].…”

mentioning

confidence: 99%

Yttrium-90 radioembolization for hepatocellular carcinoma in hepatitis B: commentary on a 103-patient Asian cohort

Kulik

Salem

2014

Hepatol Int

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“…A study of 20 patients with HCC (Child Pugh ≤B8, no vascular invasion) compared SIRT with Y-90 glass microspheres alone versus the combination of SIRT and sorafenib (treated with sorafenib 400 mg bid for 14 days before SIRT, with the intent to bridge to transplantation). The combination arm was associated with more peri-operative biliary complications than with SIRT alone (LoE III) (58). The ongoing SORAMIC study compares SIRT with Y-90 resin microspheres followed 3 days later with oral sorafenib (200 mg bid for 1 week and then 400 mg bid) vs. sorafenib alone with a matching dosing schedule in patients with Child-Pugh ≤B7 BCLC A-C class HCC.…”

Section: Rationale and Recommendationsmentioning

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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Prospective randomized pilot study of Y90+/−sorafenib as bridge to transplantation in hepatocellular carcinoma

Cited by 85 publications

References 24 publications

Combined Sorafenib and Yttrium-90 Radioembolization for the Treatment of Advanced Hepatocellular Carcinoma

Combined Sorafenib and Yttrium-90 Radioembolization for the Treatment of Advanced Hepatocellular Carcinoma

Yttrium-90 radioembolization for hepatocellular carcinoma in hepatitis B: commentary on a 103-patient Asian cohort

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

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