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Yttrium-90 Controls Liver Cancer Over Long Term -
Presented at SIR
By Ed Susman TORONTO, CANADA - April 4, 2006 - Low-risk patients with unresectable liver cancer appear to gain control over their malignancies for at least 2 years when treated with yttrium-90 in microspheres delivered via catheter, according to research presented here at the 31[st annual meeting of the Society of Interventional Radiology (SIR).
TheraSphere -- a therapy that consists of millions of microscopic, radioactive glass microspheres (20-30 microns diameter) -- is infused into the arteries that feed inoperable liver tumors, bathing the malignancy in high levels of extremely localized radiation.
Low-risk patients survived a median of 800 days compared with a median of 258 days for high risk patients (P <.0001) in a study of 140 patients (106 male) using TheraSphere, a US Food and Drug Administration-approved treatment for hepatocellular cancer. The patients underwent 238 administrations of the particles.
Similar results were seen among patients who were stratified by the Okuda and the Child-Pugh measures of disease involvement. Those at the lower ends of each scale fared better, according to Riad Salem, MD, director, interventional radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States.
"TheraSphere hepatic unilobar infusion for hepatocellular carcinoma appears to represent an efficacious therapy with acceptable toxicity," Dr. Salem said. "Survival data in hepatocellular carcinoma is promising."
Approximately 34% of patients responded to the treatment according to evaluation by Response Evaluation Criteria in Solid Tumors (RECIST) -- meaning their overall tumor burden decreased by 50% or more, Dr. Salem said. That improvement was balanced by an 11% incidence in patients experiencing Grade 3 bilirubin toxicities at 3 months following the last treatment. Most of that toxicity was attributed to disease progression, Dr. Salem added.
"Yttrium-90 appears to be a very, very promising treatment modality in patients with liver cancer," noted Janette Durham, MD, professor of radiology, University of Colorado Health Sciences Center, Denver, Colorado, United States. Dr. Durham said this study showed there is a learning curve in using the new agent, but that this therapy appears to be a powerful new instrument in treating inoperable liver tumors.
[Presentation title: Treatment of Unresectable Hepatocellular Carcinoma Using Intra-Arterial Y90 (TheraSphere): Long-Term Follow-up. Abstract 19]
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