Role of Y90 Radioembolization in Hepatic Metastatic Colorectal Carcinoma

Radioembolization is a treatment option for select patients with hepatic metastases from colorectal cancer in the salvage setting. These patients with liver-dominant or liver-only metastatic disease who have failed standard-of-care first- and second-line systemic therapies have clear and consistent objective response rates and survival outcomes from this outpatient procedure. While there is interest in combining systemic and locoregional therapies to benefit from chemoradiation principles as well as treat patients earlier in their disease course, current evidence to support this practice is lacking. Prospective randomized trials employing radioembolization in combination with first-line chemotherapy have been negative to date. Most recently, a clinical trial of second-line chemotherapy with/without radioembolization has completed enrollment in October 2018, and the study results are yet to be published.