Can Mutation Status Predict Survival After Y90 Radioembolization Therapy?
The mutational status and histopathologic grade of patients with chemorefractory colorectal liver metastases (CRLM) may predict survival after Y90 radioembolization therapy, according to a study published in Oncotarget. Patients with wild-type mutation status along with a well-differentiated tumor grade demonstrated significantly greater survival after Y90 radioembolization.
In this single institution retrospective study, 23 patients patients with CRLM underwent genomic analysis before receiving Y-90 radioembolization. Eleven (47.8%) had mutations identified (MUT), and 12 were sequenced as wild type (WT) (52.2%). After Y90 treatment, the median overall survival (OS) for all patients was 9.6 months (95% CI 6.67-16.23). From first Y90 treatment, OS was significantly greater in WT patients (16.2 months vs 6.5 months; P = 0.0054). The survival difference between poorly differentiated tumors compared to all other histologic grades was significant (poor vs well P = 0.025, HR=26.8; poor vs moderate P = 0.014, HR=23.07; poor vs moderate/poor P = 0.014, HR=23.68).
There was a difference in median OS observed between WT (16.2 months), MUT/moderate differentiation (8.0 months), and MUT/poor differentiation (3.8 months) (P < 0.0001). There was a significant difference between MUT and WT groups (P = 0.02) in imaging response via RECIST criteria.
“Mutation status could be a useful prognostic tool in the decision to treat these patients with Y-90 radioembolization,” the authors concluded.
Dendy MS, Ludwig JM, Kokabi N, et al. Genomic mutations and histopathologic biomarkers in Y90radioembolization for chemorefractory colorectal liver metastases. Oncotarget. 2018 Aug 21; 9(65): 32523–32533.