Table 5. Summary of published radiographic response rates following radioembolization (RE) in liver metastases from colorectal cancer.
Study | Design | Microsphere | Combination therapy vs. comparator | Liver-only or liver-dominant | Number evaluated for response | Response criteria | Response (%) | Median survival (months) | ||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
type | CR | PR | SD | DCR | PD | |||||||
First-line | ||||||||||||
Kosmider (10) | Retrospective | Resin | + FOLFOX4 (63%) or 5FU/LV (37%) | LD | 19 | RECIST 1.0 | 11 | 74 | 5 | 89 | 11 | 29.4 |
LO subset | 14 | 11 | 79 | 5 | 95 | 5 | 37.8 | |||||
Sharma (8) | Prospective | Resin | + FOLFOX | LD | 20 | RECIST 1.0 | 0 | 90 | 10 | 100 | 0 | NA |
van Hazel (9) | Prospective RCT | Resin | + 5FU/LV | LD | 11 | RECIST 1.0 | 0 | 73 | 27 | 100 | 0 | 29.4 |
– | vs. 5FU/LV | LD | 10 | RECIST 1.0 | 0 | 0 | 60 | 60 | 40 | 12.8 | ||
Gray (24) | Prospective RCT | Resin | + FUDR-HAC | LO | 32 | WHO | 6 | 44 | 41 | 91 | 9 | 39% at 2 y |
– | vs. FUDR-HAC | LO | 27 | WHO | 0 | 22 | 48 | 70 | 30 | 29% at 2 y | ||
Second-line or third-line | ||||||||||||
Van Hazel (7) | Prospective | Resin | + irinotecan | LD | 23 | RECIST 1.0 | 0 | 48 | 39 | 87 | 13 | 12.2 |
Lim (11) | Retrospective | Resin | + 5FU in 70% | LD | 32 | RECIST 1.0 | 0 | 31 | 28 | 59 | 41 | NA |
Chemotherapy refractory disease | ||||||||||||
Kalva (30) | Retrospective | Resin | None | LD | 41 | RECIST 1.1 | 0 | 2 | 83 | 85 | 15 | 6.1 |
Saxena (31) | Retrospective | Resin | None | LD | 293 | RECIST 1.0 | 1 | 38 | 33 | 72 | 29 | 10.5 |
Sofocleous (32) | Prospective | Resin | None | LD | 19 | RECIST 1.0 | 0 | 5 | 53 | 58 | 42 | 14.9 |
PERCIST | 0 | 33 | 20 | 53 | 47 | |||||||
Benson (33) | Prospective | Glass | None | LD | 58 | RECIST 1.0-based | 0 | 5 | 53 | 59 | 41 | 8.8 |
Smits (34) | Retrospective | Resin | None | LD | 59 | RECIST 1.1TL | 3 | 5 | 27 | 35 | 27 | 8.9 |
Seidensticker (35) | Prospective | Resin | + BSC | LD | 28 | RECIST 1.0 | 0 | 43 | 18 | 62 | 38 | 8.3 |
Retrospective | – | vs. BSC (matched-pairs) | LD | NA (of 29) | NA | NA | NA | NA | NA | NA | 3.5 | |
Martin (36) | Retrospective | Not defined | None | LD | 24 | RECIST 1.1 | 0 | 0 | NA | NA | NA | 8.9 |
Zerizer (37) | Retrospective | Resin | + FOLFOX in 20% | LD | 25 | RECIST 1.1TL | 0 | 8 | 92 | 100 | 0 | NA |
EORTC PET | 0 | 60 | 40 | 60 | 0 | |||||||
Choi | 0 | 8 | 84 | 92 | 8 | |||||||
Nace (38) | Retrospective | Resin | + FUDR HAC in 33% | LD | 31 | RECIST 1.0 | 0 | 13 | 65 | 77 | 23 | 10.2 |
Cosimelli (5) | Prospective | Resin | None | LD | 46 | RECIST 1.0 | 2 | 24 | 26 | 52 | 48 | 12.6 |
Hendlisz (6) | Prospective RCT | Resin | + 5FU | LO | 20 | RECIST 1.0 | 0 | 10 | 80 | 90 | 10 | 10 |
– | vs. 5FU (> SIRT at PD) | LO | 22 | RECIST 1.0 | 0 | 0 | 36 | 36 | 64 | 7.3 | ||
Cianni (39) | Retrospective | Resin | None | LD | 41 | RECIST 1.0 | 5 | 40 | 36 | 81 | 19 | 11.9 |
Jakobs (40) | Retrospective | Resin | None | LD | 36 | RECIST 1.0 | 0 | 19 | 70 | 89 | 11 | 10.5 |
Kennedy (17) | Retrospective | Resin | None | LD | 208 | WHO | 0 | 36 | 55 | 91 | 10 | 10.5R; 4.5NON-R |
Mixed setting (first-line through chemotherapy refractory disease) | ||||||||||||
Chua (41) | Retrospective | Resin | None | LD | 140 | RECIST 1.0 | 1 | 31 | 31 | 63 | 37 | 9 |
Mulcahy (42) | Prospective | Glass | None | LD | 72 | WHO | 0 | 40 | 45 | 85 | 15 | 14.5 |
Stubbs (43) | Retrospective | Resin | + HAC with 5FU | LD | 80 | Author-defined | 1 | 73 | 20 | 94 | 6 | 11 |
Lewandowski (44) | Prospective | Glass | None | LD | 26 | WHO | 0 | 35 | 52 | 87 | 13 | 9.3 |
LO, liver-only metastases; LD, liver-dominant metastases; CR, complete response; PR, partial response; SD, stable disease; DCR, disease control rate (CR + PR + SD); PD, progressive disease; RCT, randomized controlled trial; FUDR-HAC, floxuridine-hepatic arterial chemotherapy; NA, not available; BSC, best supportive care; TL, response in target lesions; R, (survival in) responders; NON-R, (survival in) non-responders; y, years; RECIST, Response Evaluation Criteria in Solid Tumors.