Radioembolization for Hepatocellular Carcinoma

A special issue of Current Oncology (ISSN 1718-7729). This special issue belongs to the section "Gastrointestinal Oncology".

Deadline for manuscript submissions: 31 July 2024 | Viewed by 5030

Special Issue Editor


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Guest Editor
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
Interests: hepatocellular carcinoma; cholangiocarcinoma; pancreas cancer; radioembolization; antiglycolytic therapy; tumor embolization; tumor ablation; vascular-targeted phototherapy

Special Issue Information

Dear Colleagues,

Hepatocellular carcinoma (HCC) is the most common primary liver cancer. Transarterial radioembolization (TARE), in which beta-emitting yttrium 90-loaded microspheres are injected intra-arterially into the tumor feeding artery, has been a well-established treatment option for HCC. TARE can be used as a palliative or curative treatment option depending on the stage and pattern of HCC and the dose used.

In this Special Issue, we welcome original research and review articles focused on different aspects of TARE when used in the treatment of HCC. These topics can include dosimetry for TARE, advanced imaging techniques used for dose calculation, the combination of TARE with other locoregional or systemic treatments, genetic factors influencing responses after TARE, immunological aspects of TARE, adjuvant treatments that improve the efficacy of TARE, surgical resection after TARE, and portal vein embolization using TARE, to name a select few. 

Dr. Hooman Yarmohammadi
Guest Editor

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Keywords

  • radioembolization
  • hepatocellular carcinoma
  • combination therapy
  • immunotherapy
  • dosimetry

Published Papers (4 papers)

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Research

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12 pages, 762 KiB  
Article
Outcomes of Y90 Radioembolization for Hepatocellular Carcinoma in Patients Previously Treated with Transarterial Embolization
by Ken Zhao, Sam Son, Anita Karimi, Brett Marinelli, Joseph P. Erinjeri, Erica S. Alexander, Vlasios S. Sotirchos, James J. Harding, Kevin C. Soares, Etay Ziv, Anne Covey, Constantinos T. Sofocleous and Hooman Yarmohammadi
Curr. Oncol. 2024, 31(5), 2650-2661; https://doi.org/10.3390/curroncol31050200 - 8 May 2024
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Abstract
The aim of this study was to evaluate outcomes of transarterial radioembolization (TARE) for hepatocellular carcinoma (HCC) in patients previously treated with transarterial embolization (TAE). In this retrospective study, all HCC patients who received TARE from 1/2012 to 12/2022 for treatment of residual [...] Read more.
The aim of this study was to evaluate outcomes of transarterial radioembolization (TARE) for hepatocellular carcinoma (HCC) in patients previously treated with transarterial embolization (TAE). In this retrospective study, all HCC patients who received TARE from 1/2012 to 12/2022 for treatment of residual or recurrent disease after TAE were identified. Overall survival (OS) was estimated using the Kaplan–Meier method. Univariate Cox regression was performed to determine significant predictors of OS after TARE. Twenty-one patients (median age 73.4 years, 18 male, 3 female) were included. Median dose to the perfused liver volume was 121 Gy (112–444, range), and 18/21 (85.7%) patients received 112–140 Gy. Median OS from time of HCC diagnosis was 32.9 months (19.4–61.4, 95% CI). Median OS after first TAE was 29.3 months (15.3–58.9, 95% CI). Median OS after first TARE was 10.6 months (6.8–27.0, 95% CI). ECOG performance status of 0 (p = 0.038), index tumor diameter < 4 cm (p = 0.022), and hepatic tumor burden < 25% (p = 0.018) were significant predictors of longer OS after TARE. TARE may provide a survival benefit for appropriately selected patients with HCC who have been previously treated with TAE. Full article
(This article belongs to the Special Issue Radioembolization for Hepatocellular Carcinoma)
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11 pages, 263 KiB  
Article
Safety and Efficacy of Concurrent Atezolizumab/Bevacizumab or Nivolumab Combination Therapy with Yttrium-90 Radioembolization of Advanced Unresectable Hepatocellular Carcinoma
by Alexander Villalobos, Howard Hussein Dabbous, Olivia Little, Olumide Babajide Gbolahan, Mehmet Akce, Meghan Allegra Lilly, Zachary Bercu and Nima Kokabi
Curr. Oncol. 2023, 30(12), 10100-10110; https://doi.org/10.3390/curroncol30120734 - 25 Nov 2023
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Abstract
To evaluate the safety and efficacy of combining yttrium-90 radioembolization (Y90-RE) with immune checkpoint inhibitor therapy, consecutive advanced unresectable hepatocellular carcinoma (HCC) patients treated between 2016 and 2022 with atezolizumab/bevacizumab or nivolumab within three-months pre- and post-Y90-RE were retrospectively evaluated. Tumor response and [...] Read more.
To evaluate the safety and efficacy of combining yttrium-90 radioembolization (Y90-RE) with immune checkpoint inhibitor therapy, consecutive advanced unresectable hepatocellular carcinoma (HCC) patients treated between 2016 and 2022 with atezolizumab/bevacizumab or nivolumab within three-months pre- and post-Y90-RE were retrospectively evaluated. Tumor response and treatment-related clinical/laboratory adverse events (AE) were assessed at 1 and 6 months, as well as differences in clinical and laboratory variables and median overall survival (OS) from initial treatment (whether it was Y90-RE or systemic therapy) between the two cohorts. A total of 19 patients (10 atezolizumab/bevacizumab; 9 nivolumab), comprising 84% males with median age 69 years, met the inclusion criteria. Compared to the atezolizumab/bevacizumab group, there were less males (100% vs. 67%; p = 0.02) and more ECOG ≥ 2 patients in the nivolumab group (0% vs. 33%; p = 0.02). Baseline characteristics or incidence of 6-month post-treatment any-grade AE (60% vs. 56%; p = 0.7), grade ≥ 3 AE (0% vs. 11%; p = 0.3), objective response (58% total, 60% vs. 56%; p = 0.7), and complete response (16% total; 10% vs. 22%; p = 0.8) were similar between the atezolizumab/bevacizumab and the nivolumab cohorts. Median OS was 12.9 months for the whole cohort, 16.4 months for nivolumab, and 10.7 months for atezolizumab/bevacizumab. Among patients with advanced unresectable HCC, the utilization of Y90-RE concurrently or within 90 days of nivolumab or atezolizumab/bevacizumab immunotherapy, appears to be well-tolerated and with a low incidence of severe AE. Full article
(This article belongs to the Special Issue Radioembolization for Hepatocellular Carcinoma)

Review

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12 pages, 617 KiB  
Review
Radiation Segmentectomy for Hepatocellular Carcinoma
by Muhamad Serhal, Farnaz Dadrass, Edward Kim and Robert J. Lewandowski
Curr. Oncol. 2024, 31(2), 617-628; https://doi.org/10.3390/curroncol31020045 - 23 Jan 2024
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Abstract
The application of trans-arterial radioembolization (TARE) with Yttrium-90, historically a palliative treatment option for patients with advanced hepatocellular carcinoma (HCC), is evolving. Radiation segmentectomy (RADSEG), the segmental delivery of an ablative radiation dose, is a treatment option for patients with earlier-stage HCC. This [...] Read more.
The application of trans-arterial radioembolization (TARE) with Yttrium-90, historically a palliative treatment option for patients with advanced hepatocellular carcinoma (HCC), is evolving. Radiation segmentectomy (RADSEG), the segmental delivery of an ablative radiation dose, is a treatment option for patients with earlier-stage HCC. This review presents an in-depth exploration of RADSEG, emphasizing its technical considerations, dosimetry advancements, and patient selection. The integration of RADSEG into the Barcelona Clinic Liver Cancer (BCLC) paradigm will be highlighted. RADSEG outcomes concerning safety and efficacy will be explored and compared with traditional locoregional cancer treatments like trans-arterial chemoembolization (TACE), percutaneous thermal ablation, and surgical resection, with an eye on future directions and considerations. Full article
(This article belongs to the Special Issue Radioembolization for Hepatocellular Carcinoma)
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10 pages, 450 KiB  
Review
Update on Locoregional Therapies for Liver Cancer: Radiation Segmentectomy
by Farnaz Dadrass, Alex Sher and Edward Kim
Curr. Oncol. 2023, 30(12), 10075-10084; https://doi.org/10.3390/curroncol30120732 - 23 Nov 2023
Cited by 1 | Viewed by 1501
Abstract
Over 900,000 people worldwide were diagnosed with liver cancer in 2022 alone, with hepatocellular carcinoma (HCC) accounting for 75–85% of cases. Treatment for HCC includes some combination of systemic therapies, surgery, liver transplantation, ablation, and intra-arterial therapies with transarterial chemoembolization (TACE) or transarterial [...] Read more.
Over 900,000 people worldwide were diagnosed with liver cancer in 2022 alone, with hepatocellular carcinoma (HCC) accounting for 75–85% of cases. Treatment for HCC includes some combination of systemic therapies, surgery, liver transplantation, ablation, and intra-arterial therapies with transarterial chemoembolization (TACE) or transarterial radioembolization (TARE). Currently, the Barcelona Clinic Liver Cancer (BCLC) guidelines have acknowledged liver transplantation, surgical resection, and thermal ablation as curative therapies in very early to early stage HCC (BCLC-0 and BCLC-A). While these modalities are the preferred curative treatments for a very early to early stage disease, there are challenges associated with these options, such as organ availability and patient eligibility. Current data shows the role of radiation segmentectomy as a curative therapeutic option for very early to early stage HCC that is unresectable and not amenable to ablation. As future data continues to elucidate the ability for radiation segmentectomy to achieve complete pathologic necrosis, the goal is for the BCLC staging model to acknowledge its role as a curative treatment in this patient population and incorporate it into the ever-evolving guidelines. Full article
(This article belongs to the Special Issue Radioembolization for Hepatocellular Carcinoma)
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