Yttrium-90 Radioembolization as Salvage Therapy for Liver Metastases From Colorectal Cancer

Sanjeeva P. Kalva, Rich S. Rana, Raymond Liu, Niranjan Rachamreddy, Bhavika Dave, Ashish Sharma, Suvranu Ganguli, Carlos Rabito, Eunice Kwak, Lawrence S. Blaszkowsky

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

PURPOSE:: To report safety and survival outcomes of Yttrium-90 (Y-90) radioembolization when used as salvage therapy for chemotherapy-resistant liver metastases from colorectal cancer.

METHODS:: In this IRB-approved retrospective study, 45 patients with hepatic metastases from colorectal cancer underwent Y-90 radioembolization after failure of systemic chemotherapy. Toxicities were assessed as per NCI-CTCAE and response based on RECIST and PET. Kaplan-Meier survival analysis was performed to calculate median survival, prognostic factors on univariate analysis, and Cox regression analysis for independent predictors of survival.

RESULTS:: Y-90 radioembolization was technically successful in all (100%). Twenty-three patients (51%) had no toxicities, whereas 6 patients (13%) had grade 3 toxicities, and no patients had grade 4 toxicity. Two patients died within 30 days of treatment from renal failure unrelated to the procedure. Per RECIST, 1 patient (2%) had partial response, 34 (71%) had stable disease, and 6 (13%) had progressive disease. PET response was seen in 46% of patients with 2 patients (4%) demonstrating complete and 22 (42%) demonstrating partial metabolic response. The median survival was 186 days (95% CI, 149-277 d). Response on PET was the only independent predictor of superior overall survival. Patients who had response on PET following Y-90 therapy had a median overall survival of 317 days (10.6 mo) (95% CI, 193-564 d), whereas patients with no response on PET had a median overall survival of 163 days (5.4 mo) (95% CI, 64-283 d).

CONCLUSIONS:: Y-90 radioembolization as a salvage therapy for chemotherapy-resistant hepatic metastases from colon cancer was safe and resulted in disease stability. Response on PET was an independent predictor of superior overall survival.

Original languageEnglish (US)
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
DOIs
StateAccepted/In press - Nov 4 2014

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Yttrium
Salvage Therapy
Colorectal Neoplasms
Neoplasm Metastasis
Liver
Survival
Drug Therapy
Research Ethics Committees
Kaplan-Meier Estimate
Survival Analysis
Treatment Failure
Colonic Neoplasms
Renal Insufficiency
Retrospective Studies
Regression Analysis
Safety

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Yttrium-90 Radioembolization as Salvage Therapy for Liver Metastases From Colorectal Cancer. / Kalva, Sanjeeva P.; Rana, Rich S.; Liu, Raymond; Rachamreddy, Niranjan; Dave, Bhavika; Sharma, Ashish; Ganguli, Suvranu; Rabito, Carlos; Kwak, Eunice; Blaszkowsky, Lawrence S.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, 04.11.2014.

Research output: Contribution to journalArticle

Kalva, Sanjeeva P. ; Rana, Rich S. ; Liu, Raymond ; Rachamreddy, Niranjan ; Dave, Bhavika ; Sharma, Ashish ; Ganguli, Suvranu ; Rabito, Carlos ; Kwak, Eunice ; Blaszkowsky, Lawrence S. / Yttrium-90 Radioembolization as Salvage Therapy for Liver Metastases From Colorectal Cancer. In: American Journal of Clinical Oncology: Cancer Clinical Trials. 2014.
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abstract = "PURPOSE:: To report safety and survival outcomes of Yttrium-90 (Y-90) radioembolization when used as salvage therapy for chemotherapy-resistant liver metastases from colorectal cancer.METHODS:: In this IRB-approved retrospective study, 45 patients with hepatic metastases from colorectal cancer underwent Y-90 radioembolization after failure of systemic chemotherapy. Toxicities were assessed as per NCI-CTCAE and response based on RECIST and PET. Kaplan-Meier survival analysis was performed to calculate median survival, prognostic factors on univariate analysis, and Cox regression analysis for independent predictors of survival.RESULTS:: Y-90 radioembolization was technically successful in all (100{\%}). Twenty-three patients (51{\%}) had no toxicities, whereas 6 patients (13{\%}) had grade 3 toxicities, and no patients had grade 4 toxicity. Two patients died within 30 days of treatment from renal failure unrelated to the procedure. Per RECIST, 1 patient (2{\%}) had partial response, 34 (71{\%}) had stable disease, and 6 (13{\%}) had progressive disease. PET response was seen in 46{\%} of patients with 2 patients (4{\%}) demonstrating complete and 22 (42{\%}) demonstrating partial metabolic response. The median survival was 186 days (95{\%} CI, 149-277 d). Response on PET was the only independent predictor of superior overall survival. Patients who had response on PET following Y-90 therapy had a median overall survival of 317 days (10.6 mo) (95{\%} CI, 193-564 d), whereas patients with no response on PET had a median overall survival of 163 days (5.4 mo) (95{\%} CI, 64-283 d).CONCLUSIONS:: Y-90 radioembolization as a salvage therapy for chemotherapy-resistant hepatic metastases from colon cancer was safe and resulted in disease stability. Response on PET was an independent predictor of superior overall survival.",
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T1 - Yttrium-90 Radioembolization as Salvage Therapy for Liver Metastases From Colorectal Cancer

AU - Kalva, Sanjeeva P.

AU - Rana, Rich S.

AU - Liu, Raymond

AU - Rachamreddy, Niranjan

AU - Dave, Bhavika

AU - Sharma, Ashish

AU - Ganguli, Suvranu

AU - Rabito, Carlos

AU - Kwak, Eunice

AU - Blaszkowsky, Lawrence S.

PY - 2014/11/4

Y1 - 2014/11/4

N2 - PURPOSE:: To report safety and survival outcomes of Yttrium-90 (Y-90) radioembolization when used as salvage therapy for chemotherapy-resistant liver metastases from colorectal cancer.METHODS:: In this IRB-approved retrospective study, 45 patients with hepatic metastases from colorectal cancer underwent Y-90 radioembolization after failure of systemic chemotherapy. Toxicities were assessed as per NCI-CTCAE and response based on RECIST and PET. Kaplan-Meier survival analysis was performed to calculate median survival, prognostic factors on univariate analysis, and Cox regression analysis for independent predictors of survival.RESULTS:: Y-90 radioembolization was technically successful in all (100%). Twenty-three patients (51%) had no toxicities, whereas 6 patients (13%) had grade 3 toxicities, and no patients had grade 4 toxicity. Two patients died within 30 days of treatment from renal failure unrelated to the procedure. Per RECIST, 1 patient (2%) had partial response, 34 (71%) had stable disease, and 6 (13%) had progressive disease. PET response was seen in 46% of patients with 2 patients (4%) demonstrating complete and 22 (42%) demonstrating partial metabolic response. The median survival was 186 days (95% CI, 149-277 d). Response on PET was the only independent predictor of superior overall survival. Patients who had response on PET following Y-90 therapy had a median overall survival of 317 days (10.6 mo) (95% CI, 193-564 d), whereas patients with no response on PET had a median overall survival of 163 days (5.4 mo) (95% CI, 64-283 d).CONCLUSIONS:: Y-90 radioembolization as a salvage therapy for chemotherapy-resistant hepatic metastases from colon cancer was safe and resulted in disease stability. Response on PET was an independent predictor of superior overall survival.

AB - PURPOSE:: To report safety and survival outcomes of Yttrium-90 (Y-90) radioembolization when used as salvage therapy for chemotherapy-resistant liver metastases from colorectal cancer.METHODS:: In this IRB-approved retrospective study, 45 patients with hepatic metastases from colorectal cancer underwent Y-90 radioembolization after failure of systemic chemotherapy. Toxicities were assessed as per NCI-CTCAE and response based on RECIST and PET. Kaplan-Meier survival analysis was performed to calculate median survival, prognostic factors on univariate analysis, and Cox regression analysis for independent predictors of survival.RESULTS:: Y-90 radioembolization was technically successful in all (100%). Twenty-three patients (51%) had no toxicities, whereas 6 patients (13%) had grade 3 toxicities, and no patients had grade 4 toxicity. Two patients died within 30 days of treatment from renal failure unrelated to the procedure. Per RECIST, 1 patient (2%) had partial response, 34 (71%) had stable disease, and 6 (13%) had progressive disease. PET response was seen in 46% of patients with 2 patients (4%) demonstrating complete and 22 (42%) demonstrating partial metabolic response. The median survival was 186 days (95% CI, 149-277 d). Response on PET was the only independent predictor of superior overall survival. Patients who had response on PET following Y-90 therapy had a median overall survival of 317 days (10.6 mo) (95% CI, 193-564 d), whereas patients with no response on PET had a median overall survival of 163 days (5.4 mo) (95% CI, 64-283 d).CONCLUSIONS:: Y-90 radioembolization as a salvage therapy for chemotherapy-resistant hepatic metastases from colon cancer was safe and resulted in disease stability. Response on PET was an independent predictor of superior overall survival.

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