Biomarkers associated with survival and favourable outcome of radioembolization with yttrium-90 glass microspheres for colon cancer liver metastases: Single centre experience

Rev Esp Med Nucl Imagen Mol (Engl Ed). 2022 Jul-Aug;41(4):231-238. doi: 10.1016/j.remnie.2021.08.001. Epub 2021 Aug 26.

Abstract

Objective: To determine the therapeutic effectiveness and safety of transarterial radioembolization (TARE) with Yttrium-90 in patients with colorectal cancer (CRC) liver metastases and to evaluate the prognostic value of different biomarkers.

Material and methods: This prospective longitudinal study enrolled consecutive patients with CRC liver metastases treated with TARE between November 2015 and june 2020. The therapeutic response at three and six months (RECIST1.1 criteria) and the relationship of biomarkers with therapeutic response, by calculating objective tumor response rates (ORR) and disease control (DCR), and overall survival (OS) and progression-free (PFS).

Results: Thirty TAREs were performed in 23 patients (mean age, 61.61 ± 9.13 years; 56.5% male). At three months, the objective response rate (ORR) was 16.7% and the disease control rate (DCR) 53.3%. At six months, the disease progressed in 80%. The ORR and DCR were significantly associated with age at diagnosis (P = 0.047), previous bevacizumab treatment (P = 0.008), pre-TARE haemoglobin (P = 0.008), NLR (P = 0.040), pre-TARE albumin (P = 0.012), pre-TARE ALT (P = 0.023) and tumour-absorbed dose > 115 Gy (P = 0.033). Median overall survival (OS) was 12 months (95% CI, 4.75-19.25 months) and median progression-free survival (PFS) 3 months (95% CI, 2.41-3.59). OS was significantly associated with primary tumour resection (P = 0.019), KRAS mutation (HR: 5.15; P = 0.024), pre-TARE haemoglobin (HR: 0.50; p = 0.009), pre-TARE NLR (HR: 1.65; P = 0.005) and PLR (HR: 1.01; P = 0.042).

Conclusion: TARE prognosis and therapeutic response were predicted by different biomarkers, ranging from biochemical parameters to tumour dosimetrics.

Keywords: Biomarcadores; Biomarkers; Colorectal cancer; Cáncer colorrectal; Itrio-90; Liver metastases; Metástasis hepáticas; Radioembolización; Radioembolization; Supervivencia; Survival; Yttrium-90.

MeSH terms

  • Aged
  • Biomarkers
  • Colonic Neoplasms*
  • Female
  • Humans
  • Liver Neoplasms* / secondary
  • Longitudinal Studies
  • Male
  • Microspheres
  • Middle Aged
  • Prospective Studies
  • Radiopharmaceuticals / therapeutic use
  • Retrospective Studies
  • Yttrium Radioisotopes

Substances

  • Biomarkers
  • Radiopharmaceuticals
  • Yttrium Radioisotopes
  • Yttrium-90