Yttrium-90 radioembolization for lung cancer metastases: Small institutional experience.

person Iuliia Kovalenko UPMC Harrisburg, Harrisburg, PA info_outline Iuliia Kovalenko, Wern Lynn Ng, Elham Nasrollahi, Lillian Sangha, Ekaterina Proskuriakova, Yijin Wert, Charles Reninger, Todd Hoffman

Authors person Iuliia Kovalenko UPMC Harrisburg, Harrisburg, PA info_outline Iuliia Kovalenko, Wern Lynn Ng, Elham Nasrollahi, Lillian Sangha, Ekaterina Proskuriakova, Yijin Wert, Charles Reninger, Todd Hoffman Organizations UPMC Harrisburg, Harrisburg, PA, Mount Sinai Hospital, Chicago, IL, UPMC Hillman Cancer Center, Harrisburg, PA, UPMC Hillman Cancer Center-Pinnacle, Camp Hill, PA Abstract Disclosures Research Funding No funding received None. Background: Yttrium-90 radioembolization (Y-90) is a local cancer therapy which can provide quality of life improvement with minimal systemic toxicity. Yet, it remains underused in nonconventional cancers malignancies including lung cancer liver metastases. We present institutional experience in Central PA of treating metastatic liver disease in lung cancer patients. Methods: We performed retrospective analysis of patients with lung cancer liver metastasis who underwent Y90 in a 5-year period at the UPMC Harrisburg. Modified RESIST criteria were used to assess response rates. Common terminology criteria for adverse events v3.0 was used to grade adverse events (AEs). Descriptive statistics were reported including median and range. Results: A total of 7 patients were included in the study with median age of 67. Median time from diagnosis was 13.7 months (5-41), median number of metastases was 3 (1-4), and median number of previous systemic therapies was 1 (1-4). Five patients have received two Y-90 procedures while two patients have received one Y90 procedure. All patients achieved liver partial response with median sustained response of 9.4 months (2-36). A total of 3 patients (42%) developed Grade 1 AEs including rash, abdominal pain, and liver enzymes elevation. Only two patients (28%) developed Grade 3 AEs (liver enzymes elevation). Patient’s characteristics and treatment outcomes are listed in the Table 1. Conclusions: Our institutional experience supports growing body of literature demonstrating safety of Y-90 radioembolization for the treatment of metastatic lung cancer to the liver. Heterogeneity in the individual patient response is multifactorial with further investigation required to understand which patients and at what point in their treatment would benefit from treatment the most. Patient demographics and treatment results. Patient #1 #2 # 3 # 4 # 5 # 6 # 7 Sex F M F F F F M Age 78 67 57 63 71 62 72 Cancer type SCC SNEC NSCLC SNEC AC SNEC NSCLC Time after diagnosis (months) 6 12 17 8 41 5 7 Number of metastases 3 1 3 1 4 2 4 Number of liver lesions 7 3 UC 2 UC UC UC Degree of liver involvement, % 13.20 2 58 5.3 33.4 17.61 20.40 Number of previous systemic therapies 2 2 5 2 3 1 3 Number of the Y90 radioembolizations performed 2 1 1 2 2 2 2 Total SIR-Spheres dose delivered, mCi 23.5 11.1 16.2 1) 28.8 2) 35.1 1) 16.2 2) 8.3 1) 24.3 2) 13.5 1) 13.92 2) 10.28 Total estimated lung dose received, Gy 1.1 0.91 1.8 1) 1.5 2) 3.5 1) 1.6 2) 0.7 1) 7.4 2) 3.5 1) 4.02 2) 7.02 Response PR PR PR PR PR PR PR Sustained response after Y90 4 2 2 36 2 12 8 All-grade AEs Grade 1 rash NO NO NO Grade 1 ALT/AST elevation NO Grade 1 abdominal pain Grade 3-4 AEs Grade 3 ALT/AST elevation NO Grade 3 ALT/AST elevation NO NO NO NO UC – uncountable; AEs – adverse events; NO – not observed; PR – partial response; ALT – alanine aminotransferase; AST – aspartate aminotransferase; SCC – small cell cancer; SNEC – small cell neuroendocrine carcinoma; NSCLC – non small cell lung cancer; AC - adenocarcinoma.