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Standard Laboratory Test Aids in Predicting the Success of SIRT

Sarah O'Brien

March 2014

The results of the recently released MORE (Metastatic Colorectal Cancer Liver Metastases Outcomes after Radio Embolization) study found standard laboratory tests have been confirmed as a means of predicting patient outcomes prior to selective internal radiation therapy (SIRT).

To gain further information on SIRT, First Report Managed Care conducted an interview with Andrew Kennedy, MD, an internationally renowned radiation oncologist specializing in gastrointestinal cancers and the lead investigator of the MORE study.

According to Dr. Kennedy, “[The] study results provide valuable information about specific [laboratory] values being predictive of outcomes, and suggest the possibility that proactively addressing abnormal values ahead of treatment will positively affect outcomes.”

As one of the largest radioembolizing studies, comprising data from 606 metastatic colorectal cancer (mCRC) patients at 11 US institutions, researchers have been able to address the common oncological issue of no standard of care in existence for mCRC patients who failed multiple lines of chemotherapy. “Through my research and experience, I believe that including SIRT as an option in earlier standard of care will benefit patients who are candidates for the procedure,” explained Dr. Kennedy. “The role for SIRT in first-line patients who are unable to tolerate chemotherapy has been investigated in retrospective series in small numbers. So far, response rates and tolerance are encouraging.”

The study participants were followed for a median of 8.5 months after SIRT. Fewer than 11% of patients were treated outside recommended guidelines, with grade 2 albumin being the most common at time of SIRT. Abnormal parameters were associated with statistically significantly decreased median survivals.

Currently the SIRFLOX clinical trial is underway to, “specially address the benefits of SIRT in combination with standard first-line chemotherapy and biological agents.” Additionally, Dr. Kennedy said SIRFLOX is important “to demonstrate a clinically significant increase in time to progression in order to give physicians confidence that there will be a survival impact,” which is specifically being addressed in the FOXFIRE global study.

While SIRT has been shown to improve a patient’s quality of life, there is much debate as to the effect SIRT will have on healthcare cost. Dr. Kennedy concludes by stating that as a result of SIRT, patients are, “living longer and feeling better, [which] is good news for the healthcare industry.”

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