Based on new research published in the November issue of The Journal of Nuclear Medicine, patients who fail to respond to existing first-line and second-line treatments for colorectal cancer liver metastases, also known as salvage patients, radioembolization with Y-90 microspheres could lengthen overall survival.
A systematic review performed by researchers revealed that about 50 percent of salvage patients have an overall survival of more than 12 months following this nuclear medicine therapy.
As of today, colorectal cancer stands as the third most commonly diagnosed type of cancer worldwide in men and the second in women. It is also the third most common cause of death. In about 50 percent of patients, metastases to the liver are seen at the time of diagnosis or during follow-up, which make up for a large segment of morbidity and mortality in patients.
A structured review was conducted by researchers to amass all obtainable evidence on radioembolization for the specific group of patients with colorectal cancer liver metastases.
"Although quite some reviews are printed on the subject of radioembolization, we felt that a structured and comprehensive review on survival and response data for these patients was lacking," said Charlotte E.N.M. Rosenbaum, PhD.
Rosenbaum is also the lead author of the study, titled "Radioembolization for Treatment of Salvage Patients with Colorectal Cancer Liver Metastases: A Systemic Review."
Researchers examined a total of 13 articles on Y-90 radioembolization as a monotherapy and 13 articles on Y-90 radioembolization as a combined treatment with chemotherapy. Among the studies, disease control rates (i.e., complete response, partial response and stable disease) ranged from 29-90 percent in the monotherapy studies, which included 901 patients. In the studies in which Y-90 radioembolization was conjoined with chemotherapy, involving 472 patients, disease control rates ranged from 59-100 percent.
"From the studies included in this systematic review, survival proportions of approximately 50 percent were found. Therefore, in this group of salvagecolorectal cancer liver metastases patients who otherwise have no regular treatment options and a life expectancy of less than six months, Y-90 radioembolization seems to be a hopeful treatment option," noted Rosenbaum.
"Our paper shows all published data on this subject from the first randomized trial onwards. Furthermore, we have determined 12-month survival proportions for all included articles to provide a better overview and to better allow for comparisons. Finally, this overview of the literature shows which topics have not been the focus of much research and may thus be interesting for further work," she added.