Outcomes of Therasphere Radioembolization for Colorectal Metastases

Andrea M. Abbott, Richard Kim, Sarah E. Hoffe, Bulent Arslan, Ben Biebel, Junsung Choi, Ghassan El-Haddad, Bela Kis, Jennifer Sweeney, Kenneth L. Meredith, Khaldoun Almhanna, Jonathan Strosberg, David Shibata, William J. Fulp, Ravi Shridhar

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Abstract

Abstract Introduction The liver is the most common site for colorectal cancer (CRC) metastases. Radioembolization with yttrium-90 (Y90) represents an alternative approach in the management of unresectable hepatic colorectal metastases. The objective of this study was to evaluate outcomes after treatment with Y90. Materials and Methods A retrospective review of patients undergoing Y90 glass microsphere treatment for metastatic CRC from 2009 to 2013 was conducted. Multivariable analysis (MVA) of factors related to overall survival (OS) was performed using the Cox proportional hazard and OS estimates were calculated using the Kaplan-Meier method. Results We identified 68 patients. Median and 2-year OS were 11.6 months and 34%. For patients with ≤ 25% hepatic burden of disease (HBD) and 1 chemotherapy regimen, 2-year OS was 63%. Median and 2-year OS for patients with ≤ 25% versus > 25% HBD were 19.6 months and 42% versus 3.4 months and 0% (P <.0001). Univariate analysis revealed that higher HBD, ≥ 3 lines of chemotherapy received, and higher carcinoembryonic antigen (CEA) were found to be significant predictors of worse OS. MVA revealed age, > 25% HBD, ≥ 3 lines of chemotherapy, and higher CEA were independently prognostic for increased mortality, and resected status of the primary tumor was associated with decreased mortality. The presence of extrahepatic metastases was not prognostic. Toxicities were mild and only 5 patients experienced Grade 3/4 biochemical toxicity. Conclusion Yttrium-90 was associated with acceptable OS with minimal morbidity in this series. Minimal exposure to chemotherapy and low HBD were found to be associated with better OS, however, even patients with chemotherapy-refractory disease received a benefit from treatment.

Original languageEnglish (US)
Article number193
Pages (from-to)146-153
Number of pages8
JournalClinical Colorectal Cancer
Volume14
Issue number3
DOIs
StatePublished - Sep 1 2015

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Yttrium
Neoplasm Metastasis
Survival
Liver
Drug Therapy
Colorectal Neoplasms
Mortality
Microspheres
Statistical Factor Analysis
Glass
Morbidity
Therapeutics
Neoplasms

All Science Journal Classification (ASJC) codes

  • Oncology
  • Gastroenterology

Cite this

Abbott, A. M., Kim, R., Hoffe, S. E., Arslan, B., Biebel, B., Choi, J., ... Shridhar, R. (2015). Outcomes of Therasphere Radioembolization for Colorectal Metastases. Clinical Colorectal Cancer, 14(3), 146-153. [193]. https://doi.org/10.1016/j.clcc.2015.02.002

Outcomes of Therasphere Radioembolization for Colorectal Metastases. / Abbott, Andrea M.; Kim, Richard; Hoffe, Sarah E.; Arslan, Bulent; Biebel, Ben; Choi, Junsung; El-Haddad, Ghassan; Kis, Bela; Sweeney, Jennifer; Meredith, Kenneth L.; Almhanna, Khaldoun; Strosberg, Jonathan; Shibata, David; Fulp, William J.; Shridhar, Ravi.

In: Clinical Colorectal Cancer, Vol. 14, No. 3, 193, 01.09.2015, p. 146-153.

Research output: Contribution to journalArticle

Abbott, AM, Kim, R, Hoffe, SE, Arslan, B, Biebel, B, Choi, J, El-Haddad, G, Kis, B, Sweeney, J, Meredith, KL, Almhanna, K, Strosberg, J, Shibata, D, Fulp, WJ & Shridhar, R 2015, 'Outcomes of Therasphere Radioembolization for Colorectal Metastases', Clinical Colorectal Cancer, vol. 14, no. 3, 193, pp. 146-153. https://doi.org/10.1016/j.clcc.2015.02.002
Abbott AM, Kim R, Hoffe SE, Arslan B, Biebel B, Choi J et al. Outcomes of Therasphere Radioembolization for Colorectal Metastases. Clinical Colorectal Cancer. 2015 Sep 1;14(3):146-153. 193. https://doi.org/10.1016/j.clcc.2015.02.002
Abbott, Andrea M. ; Kim, Richard ; Hoffe, Sarah E. ; Arslan, Bulent ; Biebel, Ben ; Choi, Junsung ; El-Haddad, Ghassan ; Kis, Bela ; Sweeney, Jennifer ; Meredith, Kenneth L. ; Almhanna, Khaldoun ; Strosberg, Jonathan ; Shibata, David ; Fulp, William J. ; Shridhar, Ravi. / Outcomes of Therasphere Radioembolization for Colorectal Metastases. In: Clinical Colorectal Cancer. 2015 ; Vol. 14, No. 3. pp. 146-153.
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abstract = "Abstract Introduction The liver is the most common site for colorectal cancer (CRC) metastases. Radioembolization with yttrium-90 (Y90) represents an alternative approach in the management of unresectable hepatic colorectal metastases. The objective of this study was to evaluate outcomes after treatment with Y90. Materials and Methods A retrospective review of patients undergoing Y90 glass microsphere treatment for metastatic CRC from 2009 to 2013 was conducted. Multivariable analysis (MVA) of factors related to overall survival (OS) was performed using the Cox proportional hazard and OS estimates were calculated using the Kaplan-Meier method. Results We identified 68 patients. Median and 2-year OS were 11.6 months and 34{\%}. For patients with ≤ 25{\%} hepatic burden of disease (HBD) and 1 chemotherapy regimen, 2-year OS was 63{\%}. Median and 2-year OS for patients with ≤ 25{\%} versus > 25{\%} HBD were 19.6 months and 42{\%} versus 3.4 months and 0{\%} (P <.0001). Univariate analysis revealed that higher HBD, ≥ 3 lines of chemotherapy received, and higher carcinoembryonic antigen (CEA) were found to be significant predictors of worse OS. MVA revealed age, > 25{\%} HBD, ≥ 3 lines of chemotherapy, and higher CEA were independently prognostic for increased mortality, and resected status of the primary tumor was associated with decreased mortality. The presence of extrahepatic metastases was not prognostic. Toxicities were mild and only 5 patients experienced Grade 3/4 biochemical toxicity. Conclusion Yttrium-90 was associated with acceptable OS with minimal morbidity in this series. Minimal exposure to chemotherapy and low HBD were found to be associated with better OS, however, even patients with chemotherapy-refractory disease received a benefit from treatment.",
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AU - Abbott, Andrea M.

AU - Kim, Richard

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AU - Arslan, Bulent

AU - Biebel, Ben

AU - Choi, Junsung

AU - El-Haddad, Ghassan

AU - Kis, Bela

AU - Sweeney, Jennifer

AU - Meredith, Kenneth L.

AU - Almhanna, Khaldoun

AU - Strosberg, Jonathan

AU - Shibata, David

AU - Fulp, William J.

AU - Shridhar, Ravi

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Abstract Introduction The liver is the most common site for colorectal cancer (CRC) metastases. Radioembolization with yttrium-90 (Y90) represents an alternative approach in the management of unresectable hepatic colorectal metastases. The objective of this study was to evaluate outcomes after treatment with Y90. Materials and Methods A retrospective review of patients undergoing Y90 glass microsphere treatment for metastatic CRC from 2009 to 2013 was conducted. Multivariable analysis (MVA) of factors related to overall survival (OS) was performed using the Cox proportional hazard and OS estimates were calculated using the Kaplan-Meier method. Results We identified 68 patients. Median and 2-year OS were 11.6 months and 34%. For patients with ≤ 25% hepatic burden of disease (HBD) and 1 chemotherapy regimen, 2-year OS was 63%. Median and 2-year OS for patients with ≤ 25% versus > 25% HBD were 19.6 months and 42% versus 3.4 months and 0% (P <.0001). Univariate analysis revealed that higher HBD, ≥ 3 lines of chemotherapy received, and higher carcinoembryonic antigen (CEA) were found to be significant predictors of worse OS. MVA revealed age, > 25% HBD, ≥ 3 lines of chemotherapy, and higher CEA were independently prognostic for increased mortality, and resected status of the primary tumor was associated with decreased mortality. The presence of extrahepatic metastases was not prognostic. Toxicities were mild and only 5 patients experienced Grade 3/4 biochemical toxicity. Conclusion Yttrium-90 was associated with acceptable OS with minimal morbidity in this series. Minimal exposure to chemotherapy and low HBD were found to be associated with better OS, however, even patients with chemotherapy-refractory disease received a benefit from treatment.

AB - Abstract Introduction The liver is the most common site for colorectal cancer (CRC) metastases. Radioembolization with yttrium-90 (Y90) represents an alternative approach in the management of unresectable hepatic colorectal metastases. The objective of this study was to evaluate outcomes after treatment with Y90. Materials and Methods A retrospective review of patients undergoing Y90 glass microsphere treatment for metastatic CRC from 2009 to 2013 was conducted. Multivariable analysis (MVA) of factors related to overall survival (OS) was performed using the Cox proportional hazard and OS estimates were calculated using the Kaplan-Meier method. Results We identified 68 patients. Median and 2-year OS were 11.6 months and 34%. For patients with ≤ 25% hepatic burden of disease (HBD) and 1 chemotherapy regimen, 2-year OS was 63%. Median and 2-year OS for patients with ≤ 25% versus > 25% HBD were 19.6 months and 42% versus 3.4 months and 0% (P <.0001). Univariate analysis revealed that higher HBD, ≥ 3 lines of chemotherapy received, and higher carcinoembryonic antigen (CEA) were found to be significant predictors of worse OS. MVA revealed age, > 25% HBD, ≥ 3 lines of chemotherapy, and higher CEA were independently prognostic for increased mortality, and resected status of the primary tumor was associated with decreased mortality. The presence of extrahepatic metastases was not prognostic. Toxicities were mild and only 5 patients experienced Grade 3/4 biochemical toxicity. Conclusion Yttrium-90 was associated with acceptable OS with minimal morbidity in this series. Minimal exposure to chemotherapy and low HBD were found to be associated with better OS, however, even patients with chemotherapy-refractory disease received a benefit from treatment.

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