Open AccessRadioembolization in the Setting of Systemic Therapies
Author(s) -
Tarub S. Mabud,
Ryan Hickey
Publication year - 2021
Publication title -
seminars in interventional radiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.35
H-Index - 40
eISSN - 1098-8963
pISSN - 0739-9529
DOI - 10.1055/s-0041-1735572
Subject(s) - medicine , systemic therapy , hepatocellular carcinoma , interventional radiology , dosing , selective internal radiation therapy , neuroendocrine tumors , radiology , oncology , cancer , breast cancer
90 Yttrium (Y90) radioembolization has been shown to improve outcomes for primary and metastatic liver cancers, but there is limited understanding of the optimal timing and safety of combining systemic therapies with Y90 treatment. Both therapeutic effects and toxicities could be synergistic depending on the timing and dosing of different coadministration paradigms. In particular, patients with liver-only or liver-dominant metastatic disease progression are often on systemic therapy when referred to interventional radiology for consideration of Y90 treatment. Interventional radiologists are frequently asked to offer insight into whether or not to hold systemic therapy, and for how long, prior to and following transarterial therapy. This study reviews the current evidence regarding the timing and safety of systemic therapy with Y90 treatment for hepatocellular carcinoma, metastatic colorectal carcinoma, intrahepatic cholangiocarcinoma, metastatic neuroendocrine tumors, and other hepatic metastases. A particular focus is placed on the timing, dosing, and toxicities of combined therapy.