Factors affecting outcomes of Yttrium-90 radioembolization in heavily pretreated patients with intrahepatic cholangiocarcinoma Journal Article
| Authors: | Zhao, K.; Erinjeri, J. P.; Sotirchos, V. S.; Alexander, E. S.; Moussa, A. M.; Marinelli, B.; Ziv, E.; Sofocleous, C. T.; Abou-Alfa, G. K.; Jarnagin, W. R.; Karimi, A.; Yarmohammadi, H. |
| Article Title: | Factors affecting outcomes of Yttrium-90 radioembolization in heavily pretreated patients with intrahepatic cholangiocarcinoma |
| Abstract: | Purpose: Transarterial radioembolization (TARE) is a liver-directed treatment for unresectable intrahepatic cholangiocarcinoma (ICC). The aim of this study is to evaluate factors affecting outcomes of TARE in heavily pretreated ICC patients. Methods: We evaluated pretreated ICC patients who received TARE from January 2013 to December 2021. Prior treatments included systemic therapy, hepatic resection, and liver-directed therapies, including hepatic arterial infusion chemotherapy, external beam radiation, transarterial embolization, and thermal ablation. Patients were classified based on history of hepatic resection and genomic status based on next-generation sequencing (NGS). The primary endpoint was overall survival (OS) after TARE. Results: Fourteen patients with median age 66.1 years (range, 52.4–87.5), 11 females and 3 males, were included. Prior therapies included systemic in 13/14 patients (93%), liver resection in 6/14 (43%), and liver-directed therapy in 6/14 (43%). Median OS was 11.9 months (range, 2.8–81.0). Resected patients had significantly longer median OS compared to unresected patients (16.6 versus 7.9 months; p = 0.038). Prior liver-directed therapy (p = 0.043), largest tumor diameter > 4 cm (p = 0.014), and > 2 hepatic segments involvement (p = 0.001) were associated with worse OS. Nine patients underwent NGS; 3/9 (33.3%) and had a high-risk gene signature (HRGS), defined as alterations in TP53, KRAS, or CDKN2A. Patients with a HRGS had worse median OS (10.0 versus 17.8 months; p = 0.024). Conclusions: TARE may be used as salvage therapy in heavily treated ICC patients. Presence of a HRGS may predict worse OS after TARE. Further investigation with more patients is recommended to validate these results. |
| Journal Title: | Abdominal Radiology |
| Volume: | 48 |
| Issue: | 7 |
| ISSN: | 2366-004X |
| Publisher: | Springer |
| Date Published: | 2023-07-01 |
| Start Page: | 2434 |
| End Page: | 2442 |
| Language: | English |
| DOI: | 10.1007/s00261-023-03930-0 |
| PROVIDER: | EBSCOhost |
| PROVIDER: | cinahl |
| PUBMED: | 37145313 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in PubMed and PDF -- Corresponding author is MSK author: Ken Zhao -- Source: Cinahl |
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