Phase i trial of selective internal radiation therapy for chemorefractory colorectal cancer liver metastases progressing after hepatic arterial pump and systemic chemotherapy Journal Article

  

Authors:	Sofocleous, C. T.; Garcia, A. R.; Pandit-Taskar, N.; Do, K. G.; Brody, L. A.; Petre, E. N.; Capanu, M.; Longing, A. P.; Chou, J. F.; Carrasquillo, J. A.; Kemeny, N. E.
Article Title:	Phase i trial of selective internal radiation therapy for chemorefractory colorectal cancer liver metastases progressing after hepatic arterial pump and systemic chemotherapy
Abstract:	Introduction This prospective study assessed the safety and outcomes of selective internal radiation therapy (SIRT) using yttrium-90 (90Y) resin microspheres as a salvage therapy for liver-predominant metastases of colorectal cancer in patients with documented progression after hepatic arterial chemotherapy (HAC) and systemic chemotherapy. Patients and Methods We recruited 19 patients who had received a mean of 2.9 prior lines of chemotherapy and ≥ 1 line of HAC. Dose-limiting toxicities (grade 3 or higher) were catalogued using Common Terminology Criteria for Adverse Events version 3.0. At 4 to 8 weeks and 3 to 4 months post SIRT, responses were assessed by carcinoembryonic antigen (CEA), and quantitative imaging using Response Evaluation Criteria in Solid Tumors (RECIST) and PET Response Criteria in Solid Tumors (PERCIST). Liver progression-free survival (LPFS), progression-free survival (PFS), and overall survival (OS) were calculated using Kaplan-Meier methodology. Results Median follow-up was 31.2 months after SIRT. Within 6 weeks of SIRT, 3 patients (15.8%) experienced grade 3 toxicity. There was no incidence of radiation-induced liver disease. Responses by RECIST, PERCIST, and CEA were, respectively, 0%, 20%, and 32% at 4 to 8 weeks and 5%, 33%, and 21% at 3 to 4 months post SIRT; 53% of patients had stable disease (by RECIST) at 3 to 4 months. Of 19 patients, 4 (21.1%) had liver ablation, 9 (47%) received additional HAC, and 17 (89%) received systemic chemotherapy after SIRT. Median LPFS, PFS, and OS after SIRT were 5.2 months, 2.0 months, and 14.9 months, respectively. Conclusion SIRT was well tolerated and did not prohibit subsequent treatment, resulting in a median OS of 14.9 months in this heavily pretreated population. © 2014 Elsevier Inc. All rights reserved.
Keywords:	yttrium 90; radioembolization; hepatic malignancy; hepatic arterial chemotherapy; arterially directed therapies; sirt
Journal Title:	Clinical Colorectal Cancer
Volume:	13
Issue:	1
ISSN:	1533-0028
Publisher:	Elsevier Inc.
Date Published:	2014-03-01
Start Page:	27
End Page:	36
Language:	English
DOI:	10.1016/j.clcc.2013.11.010
PROVIDER:	scopus
PUBMED:	24370352
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84895074155&partnerID=40&md5=4ecb157ce0714b1a3be468ebeba0e906
Notes:	Export Date: 2 April 2014 -- CODEN: CCCLC -- Source: Scopus

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