Impact of Genomic Mutation and Timing of Y90 Radioembolization in Colorectal Liver Metastases

Purpose To investigate timing of Yttrium-90 radioembolization (Y90) during treatment course, genomics, and other clinical factors as predictors of overall survival (OS) in colorectal liver metastasis (CRLM) that have progressed on at least one line of chemotherapy. Materials and Methods This was a r...

Full description

Saved in:
Bibliographic Details
Published in:Cardiovascular and interventional radiology 2020-07, Vol.43 (7), p.1006-1014
Main Authors: Dabrowiecki, Alexander, Sankhla, Tina, Shinn, Kaitlin, Bercu, Zachary L., Ermentrout, Mitchell, Shaib, Walid, Cardona, Kenneth, Newsome, Janice, Kokabi, Nima
Format: Article
Language:English
Subjects:
5-Fluorouracil
Bevacizumab
Cardiology
Chemotherapy
Clinical Investigation
Diagnosis
Failure analysis
Folinic acid
Genomic analysis
Imaging
Interventional Oncology
Liver
MAP kinase
Medicine
Medicine & Public Health
Metastases
Metastasis
Monoclonal antibodies
Multivariate analysis
Mutation
Nuclear Medicine
Oxaliplatin
Patients
Radiology
Survival
Tumors
Ultrasound
Yttrium
Yttrium isotopes
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose To investigate timing of Yttrium-90 radioembolization (Y90) during treatment course, genomics, and other clinical factors as predictors of overall survival (OS) in colorectal liver metastasis (CRLM) that have progressed on at least one line of chemotherapy. Materials and Methods This was a retrospective study from 2013 to 2018 of patients with CRLM and genomic analysis prior to Y90 at a multihospital tertiary referral center. OS from liver metastasis diagnosis and predictors of OS were analyzed using Kaplan–Meier estimation with log-rank and Cox regression analyses. Results Overall, 58 patients with CRLM who progressed on at least one line of chemotherapy who had genomic analysis prior to Y90 were identified. Median OS after hepatic metastasis was 29.9 months. Of these, 16 (28%) patients received Y90 after failure of the first-line systemic chemotherapy. There was significantly prolonged OS in patients receiving Y90 immediately following failure of the first-line chemotherapy folinic acid, fluorouracil, oxaliplatin ((FOLFOX) ± bevacizumab) versus following multiple lines of chemotherapy (median OS of 46.3 vs. 26.6 months, P  = 0.005). The presence of genetic mutation in tumor, MAPK pathway wild type, left-sided primary tumor, low MELD score, and non-diffuse unilobar disease were also found to be predictors prolonged survival on log-rank analysis ( P ’s 
ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-020-02463-z