90Y Radioembolization of Metastatic Breast Cancer to the Liver: Toxicity, Imaging Response, Survival

Affaan K. Bangash, Bassel Atassi, Virginia Kaklamani, Thomas K. Rhee, Maurice Yu, Robert J. Lewandowski, Kent T. Sato, Robert K. Ryu, Vanessa L. Gates, Steven Newman, Robert Mandal, William Gradishar, Reed A. Omary, Riad Salem

Research output: Contribution to journalArticle

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Abstract

Purpose: To present data from patients with breast cancer liver metastases who underwent radioembolization with yttrium (90Y) microspheres. Materials and Methods: Using standard 90Y lobar treatment protocol, 27 female patients with progressing liver metastases on standard of care polychemotherapy were treated under an open-label phase 2 protocol. After treatment, we assessed (a) tumor response using computed tomography and/or positron emission tomography, (b) biochemical toxicity, and (c) survival. Results: The mean age of the patients was 52. Seventeen (63%) patients received 20 left lobe treatments (median radiation dose, 123 Gy; mean, 119 Gy), and 20 (74%) patients received 22 right lobe treatments (median radiation dose, 121 Gy; mean, 109 Gy) to the treatment site. No significant dose-difference was noted between the two lobes (P = .69). Tumor response on 90-day follow-up computed tomography showed (a) complete and partial response in nine (39.1%) patients, (b) stable disease in 12 (52.1%) patients, and (c) progressive disease in 2 (8.8%) patients. Positive tumor response on positron emission tomography was noted in 17 (63%) patients. Three of 27 (11%) patients (Eastern Cooperation Oncology Group 1, 2, or 3) showed bilirubin toxicity of grade 3, all of which were attributed to disease progression. Median survival for Eastern Cooperation Oncology Group 0 versus 1, 2, or 3 patients was 6.8 months and 2.6 months, respectively (P = .24) and for patients with tumor burden <25% versus >25% was 9.4 and 2.0 months, respectively (P = .46). Conclusions: Radioembolization with 90Y brachytherapy device may be a viable therapeutic option for the treatment of breast cancer liver metastases in patients who have progressed or failed on standard of care polychemotherapy.

Original languageEnglish
Pages (from-to)621-628
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume18
Issue number5
DOIs
StatePublished - May 1 2007
Externally publishedYes

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Liver Neoplasms
Breast Neoplasms
Survival
Standard of Care
Neoplasm Metastasis
Combination Drug Therapy
Therapeutics
Radiation
Yttrium
Neoplasms
Brachytherapy
Patient Compliance
Clinical Protocols
Tumor Burden
Microspheres
Bilirubin
Positron-Emission Tomography
Disease Progression
Tomography
Equipment and Supplies

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

90Y Radioembolization of Metastatic Breast Cancer to the Liver : Toxicity, Imaging Response, Survival. / Bangash, Affaan K.; Atassi, Bassel; Kaklamani, Virginia; Rhee, Thomas K.; Yu, Maurice; Lewandowski, Robert J.; Sato, Kent T.; Ryu, Robert K.; Gates, Vanessa L.; Newman, Steven; Mandal, Robert; Gradishar, William; Omary, Reed A.; Salem, Riad.

In: Journal of Vascular and Interventional Radiology, Vol. 18, No. 5, 01.05.2007, p. 621-628.

Research output: Contribution to journalArticle

Bangash, AK, Atassi, B, Kaklamani, V, Rhee, TK, Yu, M, Lewandowski, RJ, Sato, KT, Ryu, RK, Gates, VL, Newman, S, Mandal, R, Gradishar, W, Omary, RA & Salem, R 2007, '90Y Radioembolization of Metastatic Breast Cancer to the Liver: Toxicity, Imaging Response, Survival', Journal of Vascular and Interventional Radiology, vol. 18, no. 5, pp. 621-628. https://doi.org/10.1016/j.jvir.2007.02.019
Bangash, Affaan K. ; Atassi, Bassel ; Kaklamani, Virginia ; Rhee, Thomas K. ; Yu, Maurice ; Lewandowski, Robert J. ; Sato, Kent T. ; Ryu, Robert K. ; Gates, Vanessa L. ; Newman, Steven ; Mandal, Robert ; Gradishar, William ; Omary, Reed A. ; Salem, Riad. / 90Y Radioembolization of Metastatic Breast Cancer to the Liver : Toxicity, Imaging Response, Survival. In: Journal of Vascular and Interventional Radiology. 2007 ; Vol. 18, No. 5. pp. 621-628.
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abstract = "Purpose: To present data from patients with breast cancer liver metastases who underwent radioembolization with yttrium (90Y) microspheres. Materials and Methods: Using standard 90Y lobar treatment protocol, 27 female patients with progressing liver metastases on standard of care polychemotherapy were treated under an open-label phase 2 protocol. After treatment, we assessed (a) tumor response using computed tomography and/or positron emission tomography, (b) biochemical toxicity, and (c) survival. Results: The mean age of the patients was 52. Seventeen (63{\%}) patients received 20 left lobe treatments (median radiation dose, 123 Gy; mean, 119 Gy), and 20 (74{\%}) patients received 22 right lobe treatments (median radiation dose, 121 Gy; mean, 109 Gy) to the treatment site. No significant dose-difference was noted between the two lobes (P = .69). Tumor response on 90-day follow-up computed tomography showed (a) complete and partial response in nine (39.1{\%}) patients, (b) stable disease in 12 (52.1{\%}) patients, and (c) progressive disease in 2 (8.8{\%}) patients. Positive tumor response on positron emission tomography was noted in 17 (63{\%}) patients. Three of 27 (11{\%}) patients (Eastern Cooperation Oncology Group 1, 2, or 3) showed bilirubin toxicity of grade 3, all of which were attributed to disease progression. Median survival for Eastern Cooperation Oncology Group 0 versus 1, 2, or 3 patients was 6.8 months and 2.6 months, respectively (P = .24) and for patients with tumor burden <25{\%} versus >25{\%} was 9.4 and 2.0 months, respectively (P = .46). Conclusions: Radioembolization with 90Y brachytherapy device may be a viable therapeutic option for the treatment of breast cancer liver metastases in patients who have progressed or failed on standard of care polychemotherapy.",
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T1 - 90Y Radioembolization of Metastatic Breast Cancer to the Liver

T2 - Toxicity, Imaging Response, Survival

AU - Bangash, Affaan K.

AU - Atassi, Bassel

AU - Kaklamani, Virginia

AU - Rhee, Thomas K.

AU - Yu, Maurice

AU - Lewandowski, Robert J.

AU - Sato, Kent T.

AU - Ryu, Robert K.

AU - Gates, Vanessa L.

AU - Newman, Steven

AU - Mandal, Robert

AU - Gradishar, William

AU - Omary, Reed A.

AU - Salem, Riad

PY - 2007/5/1

Y1 - 2007/5/1

N2 - Purpose: To present data from patients with breast cancer liver metastases who underwent radioembolization with yttrium (90Y) microspheres. Materials and Methods: Using standard 90Y lobar treatment protocol, 27 female patients with progressing liver metastases on standard of care polychemotherapy were treated under an open-label phase 2 protocol. After treatment, we assessed (a) tumor response using computed tomography and/or positron emission tomography, (b) biochemical toxicity, and (c) survival. Results: The mean age of the patients was 52. Seventeen (63%) patients received 20 left lobe treatments (median radiation dose, 123 Gy; mean, 119 Gy), and 20 (74%) patients received 22 right lobe treatments (median radiation dose, 121 Gy; mean, 109 Gy) to the treatment site. No significant dose-difference was noted between the two lobes (P = .69). Tumor response on 90-day follow-up computed tomography showed (a) complete and partial response in nine (39.1%) patients, (b) stable disease in 12 (52.1%) patients, and (c) progressive disease in 2 (8.8%) patients. Positive tumor response on positron emission tomography was noted in 17 (63%) patients. Three of 27 (11%) patients (Eastern Cooperation Oncology Group 1, 2, or 3) showed bilirubin toxicity of grade 3, all of which were attributed to disease progression. Median survival for Eastern Cooperation Oncology Group 0 versus 1, 2, or 3 patients was 6.8 months and 2.6 months, respectively (P = .24) and for patients with tumor burden <25% versus >25% was 9.4 and 2.0 months, respectively (P = .46). Conclusions: Radioembolization with 90Y brachytherapy device may be a viable therapeutic option for the treatment of breast cancer liver metastases in patients who have progressed or failed on standard of care polychemotherapy.

AB - Purpose: To present data from patients with breast cancer liver metastases who underwent radioembolization with yttrium (90Y) microspheres. Materials and Methods: Using standard 90Y lobar treatment protocol, 27 female patients with progressing liver metastases on standard of care polychemotherapy were treated under an open-label phase 2 protocol. After treatment, we assessed (a) tumor response using computed tomography and/or positron emission tomography, (b) biochemical toxicity, and (c) survival. Results: The mean age of the patients was 52. Seventeen (63%) patients received 20 left lobe treatments (median radiation dose, 123 Gy; mean, 119 Gy), and 20 (74%) patients received 22 right lobe treatments (median radiation dose, 121 Gy; mean, 109 Gy) to the treatment site. No significant dose-difference was noted between the two lobes (P = .69). Tumor response on 90-day follow-up computed tomography showed (a) complete and partial response in nine (39.1%) patients, (b) stable disease in 12 (52.1%) patients, and (c) progressive disease in 2 (8.8%) patients. Positive tumor response on positron emission tomography was noted in 17 (63%) patients. Three of 27 (11%) patients (Eastern Cooperation Oncology Group 1, 2, or 3) showed bilirubin toxicity of grade 3, all of which were attributed to disease progression. Median survival for Eastern Cooperation Oncology Group 0 versus 1, 2, or 3 patients was 6.8 months and 2.6 months, respectively (P = .24) and for patients with tumor burden <25% versus >25% was 9.4 and 2.0 months, respectively (P = .46). Conclusions: Radioembolization with 90Y brachytherapy device may be a viable therapeutic option for the treatment of breast cancer liver metastases in patients who have progressed or failed on standard of care polychemotherapy.

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