scholarly journals Labeling of Hinokitiol with 90Y for Potential Radionuclide Therapy of Hepatocellular Carcinoma

Processes ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 940
Author(s):  
Christelle Bouvry ◽  
Valérie Ardisson ◽  
Nicolas Noiret ◽  
Etienne Garin ◽  
Nicolas Lepareur

Hepatocellular carcinoma (HCC), the most common form of primary liver tumors, is the fifth cancer in the world in terms of incidence, and third in terms of mortality. Despite significant advances in the treatment of HCC, its prognosis remains bleak. Transarterial radioembolization with radiolabeled microspheres and Lipiodol has demonstrated significant effectiveness. Here we present a new, simple radiolabeling of Lipiodol with Yttrium-90, for the potential treatment of HCC.

2021 ◽  
Vol 38 (04) ◽  
pp. 453-459
Author(s):  
Grace L. Laidlaw ◽  
Guy E. Johnson

AbstractTransarterial radioembolization using yttrium-90 (Y-90) microspheres is an important therapy in the management of unresectable primary liver tumors or hepatic metastases. While radioembolization is generally well-tolerated, it is not free from adverse events, and familiarity with the prevention and treatment of radioembolization-specific complications is an important component of patient care. This article aims to review radioembolization-specific toxicities stratified by hepatic, extrahepatic, and systemic effects, with a focus on preventing and mitigating radioembolization-induced morbidity.


Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 122
Author(s):  
Julie Pellegrinelli ◽  
Olivier Chevallier ◽  
Sylvain Manfredi ◽  
Inna Dygai-Cochet ◽  
Claire Tabouret-Viaud ◽  
...  

Liver tumors are common and may be unamenable to surgery or ablative treatments. Consequently, other treatments have been devised. To assess the safety and efficacy of transarterial radioembolization (TARE) with Yttrium-90 for hepatocellular carcinoma (HCC), liver-dominant hepatic colorectal cancer metastases (mCRC), and cholangiocarcinoma (CCA), performed according to current recommendations, we conducted a single-center retrospective study in 70 patients treated with TARE (HCC, n = 44; mCRC, n = 20; CCA, n = 6). Safety and toxicity were assessed using the National Cancer Institute Common Terminology Criteria. Treatment response was evaluated every 3 months on imaging studies using Response Evaluation Criteria in Solid Tumors (RECIST) or mRECIST criteria. Overall survival and progression-free survival were estimated using the Kaplan-Meier method. The median delivered dose was 1.6 GBq, with SIR-Spheres® or TheraSphere® microspheres. TARE-related grade 3 adverse events affected 17.1% of patients. Median follow-up was 32.1 months. Median progression-free survival was 5.6 months and median overall time from TARE to death was 16.1 months and was significantly shorter in men. Progression-free survival was significantly longer in women (HR, 0.49; 95%CI, 0.26–0.90; p = 0.031). Risk of death or progression increased with the number of systemic chemotherapy lines. TARE can be safe and effective in patients with intermediate- or advanced-stage HCC, CCA, or mCRC refractory or intolerant to appropriate treatments.


2016 ◽  
Vol 33 (5) ◽  
pp. 699-714 ◽  
Author(s):  
Joseph Ralph Kallini ◽  
Ahmed Gabr ◽  
Riad Salem ◽  
Robert J. Lewandowski

2019 ◽  
Vol 57 (1) ◽  
pp. 37-46
Author(s):  
Adela Turcanu ◽  
Ecaterina Pitel ◽  
Vlada-Tatiana Dumbrava ◽  
Eugen Tcaciuc ◽  
Ana Donscaia ◽  
...  

Abstract Introduction. Moldova is the European country with the highest incidence of hepatocellular carcinoma (HCC) in both sexes. There is, however, no data comprehensively describing the presentation and the risk factors of HCC in the country. We decided to analyze cases of HCC recently received in a tertiary healthcare Institution from Chisinau, the Moldovian capital. Methods. A series of 148 primary liver tumors including 139 cases of HCC were retrospectively analyzed for demographic features, serological and biochemical data, and clinical presentation. Results. The mean age of patients was 59 ± 10 years (range: 19-66) with a M:F sex ratio of 1.9. Tumors appeared on full-blown liver cirrhosis in 83% of cases and were composed of multiple nodules at diagnosis in 36% of patients. Serum Alpha-fetoprotein was exceeding 10ng/mL in 76% of cases. Liver tumor and hepatitis were co-discovered in 34% of cases. More than 81% of hepatocellular carcinomas were associated with at least one hepatitis virus. Carriers of anti-hepatitis C virus were predominating (55% of cases) over patients seropositive for hepatitis B virus surface antigen (36%). Half of the latter were also infected with hepatitis Delta virus. In total, dual or triple infections were present in 24% and 7% of cases. Conclusions. The burden of infections with hepatitis viruses is particularly important in Moldova and corresponds to a situation commonly observed in countries of the Southern hemisphere. A pro-active policy of screening for persistent liver infection targeting population at risk of HCC (> 50 years) and coupled with the distribution of antivirals in positive cases should be rapidly implemented in Moldova to reduce incidence or primary liver cancer.


2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Calvin Young ◽  
Anusree Subramonian ◽  
Charlene Argáez

Transarterial radioembolization using yttrium-90 (90Y) microspheres is a therapeutic option for patients with intermediate- or advanced-stage hepatocellular carcinoma, including those with recurrent or inoperable hepatocellular carcinoma. Overall, the evidence suggests that patients treated with 90Y-based transarterial radioembolization may experience no difference in overall survival, progression-free survival, and tumour response when compared to patients who received transarterial chemoembolization therapies or systemic treatment with sorafenib or lenvatinib. Patients treated with transarterial radioembolization generally experienced similar rates of adverse events compared to those treated with transarterial chemoembolization, although there were some instances where treatment with transarterial radioembolization led to increased or decreased risks of specific adverse events. The comparative safety of transarterial radioembolization versus systemic treatment with sorafenib was unclear as the included studies did not statistically compare the risks of experiencing adverse events. Evidence regarding the cost-effectiveness of 90Y microspheres for treating hepatocellular carcinoma is conflicting. Three economic evaluations suggest treatment with transarterial radioembolization is likely to be cost-effective or dominant — less costly and more effective — compared to transarterial chemoembolization or systemic therapies, while a single economic study suggested treatment with sorafenib or lenvatinib is most likely to be cost-effective or dominant compared to transarterial radioembolization.


2020 ◽  
Vol 13 (1) ◽  
pp. 158-163
Author(s):  
Nicholas Pigg ◽  
Daniel Aboubechara ◽  
Roberto Fourzali ◽  
Brian Baigorri

Use of yttrium-90 (Y-90) is used for primary liver tumors and a handful of liver metastatic lesions. Y-90 treatment for metastatic adrenocortical carcinoma (ACC) to the liver is currently off-label, with one previously documented case report. In this case report, we present a 52-year-old woman with ACC and extensive liver metastatic disease. After failed chemotherapy, multidisciplinary discussion suggested potential Y-90 treatment for palliative purposes. After undergoing Y-90 treatment separately to the right and then the left hepatic lobes, subsequent patient visits demonstrated significantly improved clinical function as well as complete radiographic resolution of liver metastatic disease mainly from ACC. This case report demonstrates the potential efficacy of Y-90 for off-label uses in liver metastatic disease. This case and similar cases may open the door to a wide variety of potential indications for Y-90 treatment.


2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 458-458
Author(s):  
Mu-Han Lin ◽  
Babak Saboury ◽  
Homan Mohammadi ◽  
Fred M Moeslein ◽  
Michael David Chuong

458 Background: Transarterial chemoembolization (TACE) and selective internal radiation therapy (SIRT) are commonly used for treatment of liver tumors. The use of TACE, which is macroembolic, prior to SIRT may cause hemodynamic changes in tumor vasculature that impair yttrium-90 (90Y) microsphere delivery to the targeted lesions. This work aims to quantify dosimetric tumor coverage using positron emission tomography (PET) dosimetry after SIRT alone compared to TACE followed by SIRT. Methods: A total of 40 consecutive hepatocellular carcinoma (HCC) SIRT patients who had a post-SIRT PET scan were evaluated. Yttrium-90 PET scan was performed within 2 hours after completion of SIRT. 3D dose distribution of each patient was then reconstructed from the PET images. To quantify the quality of SIRT microsphere delivery, we evaluated the selectivity index (SI) defined as the ratio of the average dose inside the treated lesion(s) and the average dose of the normal liver. The SI values of patients were compared based on whether TACE was previously used. Results: Thirty patients had complete data for analysis. The average dose for a total of 125 targeted lesions was 106 Gy (range 0 Gy – 495 Gy). The average SI of the entire patient group was 3.0, indicating that the targeted lesion dose was three times higher than normal liver dose. The average SI was 1.7 for the 13 patients who had prior TACE and 3.8 for the 17 patients who did not have prior TACE (p = 0.01). Nearly 80% of the patients with prior TACE demonstrated poor 90Ymicrosphere delivery (SI < 2) while none demonstrated excellent microsphere delivery (SI > 4). On the other hand, the incidence of SI < 2 and SI > 4 among patients with no prior TACE was 24% and 40%, respectively. Conclusions: 3D dose evaluation using post-SIRT PET suggests that 90Y microsphere delivery to liver tumors is impaired among patients who received prior TACE compared to those who receive SIRT alone. These data warrant evaluation of clinical outcomes in SIRT patients based on prior use of TACE and may provide a rationale for the use of SIRT prior to TACE.


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