Can Y-90 Radioembolization Treat Metastases From Pancreatic Adenocarcinoma?

Radioembolization with yttrium-90 (Y-90) microspheres may be an effective second-line therapy for patients with liver metastases from pancreatic adenocarcinoma, according to a study published in the Journal of Vascular and Interventional Radiology.

The retrospective study involved 33 patients with metastatic pancreatic adenocarcinoma. Their cancer had progressed even after they had received systemic chemotherapy and other treatments directed at primary tumors metastases. From 2011 through 2017, the patients were treated with Y-90 radioembolization, after which laboratory and imaging studies were conducted and tumor response was evaluated.

For this study, the researchers analyzed imaging studies at 2, 4, 8, and 12 weeks post-treatment. Based on imaging results, a partial response was seen in 8 patients (42%), while stable disease was seen in 7 (37%) and progressive disease in 4 (21%). Patients survived for a median of 8.1 months after radioembolization and 20.8 months after the primary tumor diagnosis.

There was no major hepatic toxicity as a result of radioembolization, the researchers noted, and “changes in liver enzyme levels were rarely grade ≥ 3 during the 12-week follow-up,” they said. However, there were some exceptions, which were 1 patient who had grade 3 increased alkaline phosphatase in week 2 and bilirubin levels in week 4, one patient who had increased bilirubin level in week 12, and 1 patient who had decreased albumin level in week 12.

Adverse events were mostly confined to grade ≤ 2, although 2 patients had short-term radioembolization-related grade 3 abdominal distention, abdominal pain, fatigue, or ascites.

“Yttrium-90 radioembolization provided a meaningful survival benefit in patients with liver metastases from pancreatic adenocarcinoma that progressed despite previous therapies. Adverse events and liver toxicity were tolerable and only occasionally severe (grade ≥ 3),” the researchers concluded.

Reference

Kim AY, Frantz S, Brower J, Akhter N. Radioembolization with yttrium-90 microspheres for the treatment of liver metastases of pancreatic adenocarcinoma: a multicenter analysis. J Vasc Interv Radiol. 30(3):292-304.e2