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 J Gradishar, Reed A. Omary, Riad Salem*

*Corresponding author for this work

Research output: Contribution to journalArticle

68 Citations (Scopus)

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

Fingerprint

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
  • Cardiology and Cardiovascular Medicine

Cite this

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 J ; 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.
@article{982b130e0176485baa1f82e9b134e32c,
title = "90Y Radioembolization of Metastatic Breast Cancer to the Liver: Toxicity, Imaging Response, Survival",
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.",
author = "Bangash, {Affaan K.} and Bassel Atassi and Virginia Kaklamani and Rhee, {Thomas K.} and Maurice Yu and Lewandowski, {Robert J} and Sato, {Kent T} and Ryu, {Robert K.} and Gates, {Vanessa L.} and Steven Newman and Robert Mandal and Gradishar, {William J} and Omary, {Reed A.} and Riad Salem",
year = "2007",
month = "5",
day = "1",
doi = "10.1016/j.jvir.2007.02.019",
language = "English (US)",
volume = "18",
pages = "621--628",
journal = "Journal of Vascular and Interventional Radiology",
issn = "1051-0443",
publisher = "Elsevier Inc.",
number = "5",

}

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 J; 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

TY - JOUR

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 J

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.

UR - http://www.scopus.com/inward/record.url?scp=34247495910&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34247495910&partnerID=8YFLogxK

U2 - 10.1016/j.jvir.2007.02.019

DO - 10.1016/j.jvir.2007.02.019

M3 - Article

C2 - 17494843

AN - SCOPUS:34247495910

VL - 18

SP - 621

EP - 628

JO - Journal of Vascular and Interventional Radiology

JF - Journal of Vascular and Interventional Radiology

SN - 1051-0443

IS - 5

ER -