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Purpose <p>To investigate relationships between treatment week, relative to Ytrrium-90 (<sup>90</sup>Y) glass microsphere calibration (i.e., specific activity and particle density), and outcomes for hepatocellular carcinoma (HCC) or colorectal cancer liver metastasis (mCRC).</p> Methods <p>Multinational, multicenter study TARGET (retrospective; <i>n</i> = 209 HCC patients) was combined with EPOCH (phase III trial; <i>n</i> = 428 mCRC patients). Efficacy included overall response rate (ORR), overall survival (OS), progression-free survival (PFS), hepatic PFS, and tumour marker response rates. Safety included clinical and laboratory toxicity. Retrospective multicompartment dosimetry, tumour and normal tissue absorbed dose were available for TARGET; single compartment dosimetry was available for EPOCH.</p> Results <p>No efficacy relationship was found relative to treatment week for TARGET or EPOCH. mRECIST ORR in TARGET for weeks 1 and 2 were 74/125 (59.2%) and 55/84 (65.5%), and by RECIST 1.1 in EPOCH were 54/142 (38.0%) and 15/43 (34.9%), respectively (<i>p</i> &gt; 0.05). Median OS for TARGET weeks 1 and 2 were 21.4 and 20.3&#xa0;months (<i>p</i> = 0.07), and in EPOCH were 14.9 and 16.4&#xa0;months, respectively (<i>p</i> = 0.37). No difference in the TARGET primary endpoint of hyperbilirubinemia was noted for weeks 1 and 2, odds ratio 0.64, <i>p</i> = 0.59. TARGET ≥ grade 3 device-related adverse events (AEs) for weeks 1 (16.8%) and 2 (26.2%) were not significantly different (<i>p</i> = 0.11). EPOCH rates of ≥ grade 3 asthenia for weeks 1 (9.2%) and 2 (23.3%) were statistically different (<i>p</i> = 0.01).</p> Conclusions <p>No efficacy treatment benefit for week 2 versus week 1 was observed in TARGET or EPOCH, but week 2 treatment trended towards a higher rate and severity of specific AEs.</p>

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The relationship between yttrium-90 glass microspheres specific activity, particle density and treatment outcomes in HCC and mCRC

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月22日

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  • Marnix G. E. H. Lam,
  • Etienne Garin,
  • Kirk D. Fowers,
  • Armeen Mahvash,
  • Siddharth A. Padia,
  • Riad Salem

摘要

Purpose

To investigate relationships between treatment week, relative to Ytrrium-90 (90Y) glass microsphere calibration (i.e., specific activity and particle density), and outcomes for hepatocellular carcinoma (HCC) or colorectal cancer liver metastasis (mCRC).

Methods

Multinational, multicenter study TARGET (retrospective; n = 209 HCC patients) was combined with EPOCH (phase III trial; n = 428 mCRC patients). Efficacy included overall response rate (ORR), overall survival (OS), progression-free survival (PFS), hepatic PFS, and tumour marker response rates. Safety included clinical and laboratory toxicity. Retrospective multicompartment dosimetry, tumour and normal tissue absorbed dose were available for TARGET; single compartment dosimetry was available for EPOCH.

Results

No efficacy relationship was found relative to treatment week for TARGET or EPOCH. mRECIST ORR in TARGET for weeks 1 and 2 were 74/125 (59.2%) and 55/84 (65.5%), and by RECIST 1.1 in EPOCH were 54/142 (38.0%) and 15/43 (34.9%), respectively (p > 0.05). Median OS for TARGET weeks 1 and 2 were 21.4 and 20.3 months (p = 0.07), and in EPOCH were 14.9 and 16.4 months, respectively (p = 0.37). No difference in the TARGET primary endpoint of hyperbilirubinemia was noted for weeks 1 and 2, odds ratio 0.64, p = 0.59. TARGET ≥ grade 3 device-related adverse events (AEs) for weeks 1 (16.8%) and 2 (26.2%) were not significantly different (p = 0.11). EPOCH rates of ≥ grade 3 asthenia for weeks 1 (9.2%) and 2 (23.3%) were statistically different (p = 0.01).

Conclusions

No efficacy treatment benefit for week 2 versus week 1 was observed in TARGET or EPOCH, but week 2 treatment trended towards a higher rate and severity of specific AEs.