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New Minimal-invasive Treatment, Y-90 Safer for Metastatic Breast Cancer Patients

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Based on research that was presented at the Society of Radiology" href="/tag/Interventional-Radiology.html">Interventional Radiology's 39th Annual Scientific Meeting, minimally invasive treatment that delivers cancer-killing radiation directly to tumors shows major promise in treating breast cancer that has moved to the liver, when no other treatment options remain available.

The study has been noted as the largest of its kind, with researchers examining treatment outcomes of 75 women (ages 26-82) with chemotherapy-resistant breast cancer liver metastases, which were too large or too many to effectively treat with other therapies. The outpatient treatment, called yttrium-90 (Y-90) radioembolization, was regarded as safe and provided disease stabilization in 98.5 percent of the women's treated liver tumors.

"Although this is not a cure, Y-90 radioembolization can shrink liver tumors, relieve painful symptoms, improve the quality of life and potentially extend survival. While patient selection is important, the therapy is not limited by tumor size, shape, location or number, and it can ease the severity of disease in patients who cannot be treated effectively with other approaches," said associate professor of radiology at Northwestern University Feinberg School of Medicine in Chicago, Robert J. Lewandowski, M.D., FSIR.

Just about 235,000 new cases of invasive breast cancer are diagnosed on an annual basis. From these, around half of the patients who develop metastatic disease will have cancer spread (metastasize) to the liver, clarified Lewandowski.

"While chemotherapy is the standard treatment for these women, many will either have progressive liver disease despite multiple different treatment regimens while others will not tolerate the side effects from toxic agents. Currently, patients are considered for Y-90 radioembolization when they have no other treatment options," he said.

As for the process itself, Y-90 radioembolization is a minimally invasive, image-guided therapy where an interventional radiologist inserts a small tube, or catheter, through an incision cut in the groin and directs it through the blood vessels and into the artery that supplies the liver. Micro beads are then dropped into the blood stream, drift out to the smaller vessels that nourish the tumor and release cancer-killing radiation from inside the tumor. And since Y-90 is targeted directly to the tumor, radiation damage to surrounding healthy tissues is significantly reduced.

"The value of Y-90 radioembolization in treating patients with non-operative primary liver cancer and metastatic colon cancer has been demonstrated. Given the low toxicity and high disease control rates, this therapy is expanding to other secondary hepatic malignancies. We're looking to gain maximal tumor control while minimizing toxicity and preserving quality of life," said Lewandowski.

As for this study, imaging follow-up was presented for 69 of the 75 women treated. In all of these women, liver tumors were growing before treatment had commenced. Following radioembolization, there was disease control in 98.5 percent of the liver tumors, with more than 30 percent reduction in tumor size for 24 women. The treatment also exhibited minimal side effects.

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