Yttrium-90 Hepatic Radioembolization for Advanced Chemorefractory Metastatic Colorectal Cancer: Survival Outcomes Based on Right- Versus Left-Sided Primary Tumor Location

Wu, Vincent T.; Li, Matthew; Goodwin, Justin; Wehrenberg-Klee, Eric; Zurkiya, Omar; Kalva, Sanjeeva P.; Ganguli, Suvranu

doi:10.2214/ajr.20.25315

Cited by 4 publications

(10 citation statements)

References 47 publications

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“…Wu et al, 14 in a RS, analyzed data from 99 patients, and recorded that higher risk of death is associated with: right-sided CRC (HR = 1.74; P = 0.03); lung-shunt fraction > 10% (HR = 1.89; P = 0.02); alkaline phosphatase > 150 U/L (HR = 1.90; P = 0.004); total bilirubin > 1.0 mg/dL (HR = 1.94; P = 0.02); CEA levels > 20 ng/mL (HR = 1.90; P = 0.02); liver-tumor volume percentage > 15% (HR = 1.96; P = 0.002); no post-Y90-RE systemic therapy (HR = 3.18; P < 0.001). The multivariate analysis showed that the only independent predictors associated with a higher survival are: right-sided colon cancer, alkaline phosphatase > 150 U/L, total bilirubin > 1.0 mg/dL, liver-tumor volume percentage > 15%, and not-receiving post-Y90-RE systemic therapies.…”

Section: Clinical Predictorsmentioning

confidence: 99%

“…In 10 of the 14 papers selected for the present SR are reported details of the Y90-RE range, median, and mean administered activity (Table 2). [5][6][7][8][9][10][11][12][13][14] In 4 of these studies are described the values of minimum administered activity, ranging from 0.20 to 0.81 GBq, maximum values, ranging from 1.68 to 9.50 GBq, and the median administered activity values, ranging from 1.08 to 1.89 GBq with an average value of the medians of 1.53 GBq (Fig. 2).…”

Section: Administered Activitymentioning

confidence: 99%

“…In 12 of the selected studies, 1 PS and 11 RS are reported evidence on predictors of therapeutic efficacy in patients undergone Y90-RE treatment for CRC-LM. [5][6][7][8][9][10][11][12][13][14][15][16] These factors can be categorized into 3 major groups: clinical, imaging, and genomic predictors.…”

Section: Predictors Of Efficacymentioning

confidence: 99%

“…Ten studies, 7 RS and 5 PS reported on these outcome measures and are presented in chronological order. 5,7,[9][10][11][14][15][16][17][18] Toxicity, if reported, is referred according to the Common Terminology Criteria for Adverse Events.…”

Section: Impact Of Y90-re On Osmentioning

confidence: 99%

“…Wu et al, 14 in a RS, analyzed 99 patients undergoing Y90-RE as salvage therapy for advanced chemorefractory CRC-LM. Eightynine patients had already receiver 2 or more lines of systemic chemotherapy.…”

Section: Impact Of Y90-re On Osmentioning

confidence: 99%

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Yttrium-90 Radioembolization of Colorectal Cancer Liver Metastases

D'Andrea

Russi²,

Pacilio

et al. 2022

American Journal of Clinical Oncology

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The present work aims to review the clinical evidence of survival outcome after treatment of colorectal cancer liver metastases using yttrium-90 radioembolization, existence, and relevance of clinical, imaging, and genomic predictors of treatment efficacy and the amount of administered activity. Publications listed in PubMed between July 2016 and May 2021 were screened. Predictors of overall survival were reported and distinguished in clinical, imaging, and genomic variables. Administered activity is reported as median and mean value; overall survival is presented as a median value from the treatment. Fourteen papers resulted to be eligible for this systematic review, 11 retrospective, and 3 prospective studies. Ten studies reported administered activity data, with an average mean administered activity of 1.63 GBq and an average median administered activity of 1.53 GBq. Many clinical, imaging and genomic variables have been identified or defined as predictors of efficacy, leading to the possibility of improvements in patient selection criteria. The overall survival resulted to be about 9 months. The clinical evidence on the application of radioembolization with yittrium-90 resumed in this work underlines the importance to analyze several clinical, imaging, and genomic variables to predict the outcome of the therapy. The overall survival has not improved significantly with respect to older studies. Further developments on treatment planning and patient selection could lead to better clinical outcomes.

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Section: Clinical Predictorsmentioning

confidence: 99%

Section: Administered Activitymentioning

confidence: 99%

Section: Predictors Of Efficacymentioning

confidence: 99%

Section: Impact Of Y90-re On Osmentioning

confidence: 99%

Section: Impact Of Y90-re On Osmentioning

confidence: 99%

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Yttrium-90 Radioembolization of Colorectal Cancer Liver Metastases

D'Andrea

Russi²,

Pacilio

et al. 2022

American Journal of Clinical Oncology

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American Radium Society Appropriate Use Criteria for the use of liver‐directed therapies for nonsurgical management of liver metastases: Systematic review and guidelines

Hallemeier

Sharma

Anker

et al. 2023

Cancer

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The liver is a common site of cancer metastases. Systemic therapy is widely accepted as the standard treatment for liver metastases (LM), although select patients with liver oligometastases may be candidates for potentially curative liver resection. Recent data support the role of nonsurgical local therapies such as ablation, external beam radiotherapy, embolization, and hepatic artery infusion therapy for management of LM. Additionally, for patients with advanced, symptomatic LM, local therapies may provide palliative benefit. The American Radium Society gastrointestinal expert panel, including members representing radiation oncology, interventional radiology, surgical oncology, and medical oncology, performed a systemic review and developed Appropriate Use Criteria for the use of nonsurgical local therapies for LM. Preferred Reporting Items for Systematic reviews and Meta‐Analyses methodology was used. These studies were used to inform the expert panel, which then rated the appropriateness of various treatments in seven representative clinical scenarios through a well‐established consensus methodology (modified Delphi). A summary of recommendations is outlined to guide practitioners on the use of nonsurgical local therapies for patients with LM.

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Are survival outcomes dependent on the tumour dose threshold of 139 Gy in patients with chemorefractory metastatic colorectal cancer treated with yttrium-90 radioembolization using glass particles? A real-world single-centre study

Topcuoglu,

Orhan,

Gormez

et al. 2024

British Journal of Radiology

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Objectives To compare the survival and objective response rate (ORR) of the patients receiving estimated tumor absorbed dose (ETAD) <140 Gy versus ETAD ≥140 Gy in patients with advanced chemorefractory colorectal carcinoma liver metastases (CRCLM) treated with yttrium-90 transarterial radioembolization (90Y TARE). Materials and Methods Between August 2016 and August 2023 adult patients with unresectable, chemorefractory CRCLM treated with 90Y TARE using glass particles, were retrospectively enrolled. Primary outcomes were overall survival (OS) and hepatic progression free survival (hPFS). Secondary outcome was ORR. Results A total of 40 patients with a mean age of 66.2 ± 7.8 years met the inclusion criteria. Mean ETAD for the group 1 (ETAD <140 Gy) and group 2 (ETAD ≥140) were 131.2 ± 17.4 Gy versus 195 ± 45.6 Gy, respectively. The mean OS and hPFS for group 1 versus group 2 were 12 ± 10.3 months and 8.1 ± 9.3 months versus 9.3 ± 3 months and 7.1 ± 8.4 months, respectively and there were no significant differences (p = 0.181 and p = 0.366, respectively). ORR did not show significant difference between groups (p = 0.432). Conclusion In real-world practice, no significant difference was found in OS, hPFS and ORR between patients who received ETAD <140 Gy versus ETAD ≥140 Gy in patients with CRCLM, in this series. Advances in knowledge This study demonstrated that increased tumour absorbed doses in radioembolization may not provide additional significant advantage for OS and hPFS for patients with CRCLM.

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Yttrium-90 Hepatic Radioembolization for Advanced Chemorefractory Metastatic Colorectal Cancer: Survival Outcomes Based on Right- Versus Left-Sided Primary Tumor Location

Cited by 4 publications

References 47 publications

Yttrium-90 Radioembolization of Colorectal Cancer Liver Metastases

Yttrium-90 Radioembolization of Colorectal Cancer Liver Metastases

American Radium Society Appropriate Use Criteria for the use of liver‐directed therapies for nonsurgical management of liver metastases: Systematic review and guidelines

Are survival outcomes dependent on the tumour dose threshold of 139 Gy in patients with chemorefractory metastatic colorectal cancer treated with yttrium-90 radioembolization using glass particles? A real-world single-centre study

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