Radioembolisation with 90Y-labelled resin microspheres in the treatment of liver metastasis from breast cancer

Cianni, Roberto; Pelle, Giuseppe; Notarianni, E.; Saltarelli, A.; Rabuffi, Paolo; Bagni, Oreste; Filippi, Luca; Cortesi, Enrico

doi:10.1007/s00330-012-2556-5

Cited by 63 publications

(49 citation statements)

References 15 publications

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“…Radioembolization is known to be a useful tool in treating primary and secondary tumors of the liver [8]. In particular, several published papers reported that 90 Y radioembolization can be effective and safe in hepatic NET [6].…”

Section: Discussionmentioning

confidence: 99%

Sequential Use of 90Y Microspheres Radioembolization and 177Lu-Dotatate in Pluri-Metastatic Neuroendocrine Tumors: A Case Report

Filippi

Ciorra

Sardella

et al. 2014

Nucl Med Mol Imaging

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90 Y radioembolization and peptide-receptor radionuclide therapy (PRRT) with 177 Lu-DOTATATE are both effective treatments for patients with inoperable neuroendocrine metastatic tumors (NET). We report the case of a 72-year-old man with severe functional syndrome due to a metastatic NET. 68 Ga-DOTATOC positron-emission tomography (PET) revealed high somatostatin receptor expression in a gross liver metastasis, in one abdominal lymph node and in several s k e l e t a l l e s i o n s . T h e p a t i e n t u n d e r w e n t l i v e r radioembolization with 90 Y-resin microspheres followed by four cycles of PRRT with 177 Lu-DOTATATE. After 3 months, a complete remission of the functional syndrome was observed. 68 Ga-DOTATOC PET demonstrated a complete response for skeletal and lymph nodal lesions with a residual bulky mass in the liver. Therefore a further 90 Y radioembolization was performed as consolidation treatment for the hepatic lesion. Six months after these combined treatments, 68 Ga-DOTATOC PET demonstrated complete metabolic response in liver and stable extrahepatic lesions. No significant long-term adverse reactions were registered. To our knowledge, the sequential use of 90 Y radiembolization before and after PRRT in a liver-dominant advanced NET has not been reported in the literature and this case suggests that these combined treatments can be safe and effective.

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Section: Discussionmentioning

confidence: 99%

Sequential Use of 90Y Microspheres Radioembolization and 177Lu-Dotatate in Pluri-Metastatic Neuroendocrine Tumors: A Case Report

Filippi

Ciorra

Sardella

et al. 2014

Nucl Med Mol Imaging

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“…Although these studies all showed positive results with SIRT in this setting, none reported on the combination of SIRT with other therapies (10,(103)(104)(105)(106)(107)(108). Experienced SIRT teams regularly treating breast cancer metastases advise caution in total activity delivered in those patients with several years of chemotherapy exposure.…”

Section: Metastatic Breast Cancermentioning

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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“…Four studies reported the median OS of BRCLM after RE ranging from 11.5 months to 14.2 months (table 1). Mild to moderate post-embolization syndrome of nausea, vomiting, fever and mild right upper quadrant pain occurred in almost all patients whereas severe toxicities like grade 1 to 3 gastrointestinal toxicities, stomach ulcers and sever hepatic failure were rare [36,37,38,39]. …”

Section: Secondary Liver Cancers Other Than From Colorectal Cancersmentioning

confidence: 99%

Yttrium-90 Microspheres: A Review of Its Emerging Clinical Indications

Khajornjiraphan¹,

Thu²,

Chow³

2014

Liver Cancer

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Background: Many patients with liver malignancies are not candidates for resection, and systemic therapies are often not effective. Radioembolization (RE) is an alternative treatment for this group of patients. The safety and efficacy of RE with yttrium 90 (Y90) in patients with hepatocellular carcinoma (HCC) or metastatic colon cancer to the liver have been proven in several studies. However, fewer studies have focussed on the safety and efficacy of RE with Y90 in other extrahepatic primary and secondary liver cancers. The effect on outcomes of concomitant use of Y90 with a systemic therapy is still currently under investigation. Summary: A review of the published data on the use of RE as stand-alone, concomitant or sequential with other treatment modalities in HCC and other primary and secondary liver cancer is reported here. Key message: RE for the treatment of HCC and other extrahepatic, primary and secondary liver cancer has reasonable efficacy and acceptable toxicities. Definitive studies to establish the role of RE in the treatment of such malignancies are warranted.

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Radioembolisation with 90Y-labelled resin microspheres in the treatment of liver metastasis from breast cancer

Abstract: (90)Y RE is effective in the treatment of liver metastases from breast cancer. We demonstrated a relevant survival and encouragingly high response rate in patients with treatment-refractory disease.

Cited by 63 publications

References 15 publications

Sequential Use of 90Y Microspheres Radioembolization and 177Lu-Dotatate in Pluri-Metastatic Neuroendocrine Tumors: A Case Report

Sequential Use of 90Y Microspheres Radioembolization and 177Lu-Dotatate in Pluri-Metastatic Neuroendocrine Tumors: A Case Report

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

Yttrium-90 Microspheres: A Review of Its Emerging Clinical Indications

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