Transarterial radioembolization for liver metastases of non-colorectal origin: safety and effectiveness results from the prospective multicenter CIRSE registry for SIR-spheres therapy (CIRT)

Abstract Purpose Trans-arterial radioembolization (TARE) is established as a treatment for colorectal liver metastases and may also be beneficial in other tumour entities. This prospective analysis aimed to evaluate the safety and effectiveness of TARE in patients with liver metastases of non-colorectal origin. Material and methods Data were extracted from the prospective, multicentre, observational CIRSE Registry for SIR-Spheres Therapy (CIRT). Adult patients with liver metastases of non-colorectal origin, including neuroendocrine tumours (NET), breast cancer, pancreatic cancer and melanoma treated with TARE Yttrium-90 resin microspheres, were included. Safety and survival analyses were conducted. Assessment for independent prognostic factors was conducted using Cox proportional hazards models. Adverse events were defined according to the CTCAE 4.03. Results A total of 169 patients underwent TARE: NET (n = 58), breast cancer (n = 47), pancreatic cancer (n = 32), and melanoma (n = 32) with median follow-up of 19.3, 9.6, 5.6 and 14.8 months, respectively. Median overall survival (OS) was 33.3 (22.4-NA), 10.7 (7.7–16.3), 5.6 (4.9–10.1), 14.7 (8.7–27) months, for the NET, breast cancer, pancreatic cancer and melanoma cohorts, respectively. Overall, severe adverse events (grade ≥ 3) occurred in 10% (17/169) of patients. Independent predictors of poorer OS included Albumin-bilirubin (ALBI) grade A2 in the NET and breast cancer cohort, and an Aspartate transaminase to Platelet Ratio Index (APRI) value of > 0.40 in the NET and melanoma cohorts. Conclusion These findings support the safety and effectiveness of TARE for liver metastases of non-colorectal origin, justifying its implementation in the treatment algorithms. Prospective studies are needed to identify which patient groups benefit most.