Can TARE-Y90 Treat Pediatric Patients?

Transarterial radioembolization with yttrium-90 (TARE-Y90) may be worth considering as an adjunctive therapy for pediatric patients with unresectable hepatic malignancies, according to a study published in Pediatric Blood Cancer.

“TARE-Y90 of unresectable primary liver malignancy is both technically feasible and demonstrates an anticancer effect, and retreatment is well tolerated,” the researchers stated.

Primary malignant tumors comprise only 1% to 2% of childhood cancers, but alternatives are still needed for patients in whom chemotherapy fails. In such cases, TARE-90 may help to bridge to surgical resection or liver transplant, or be used for palliation.

For their study, the authors retrospectively reviewed data from 10 pediatric patients who were treated with TARE-90 after having histologically confirmed primary liver malignancy. At treatment, patients had a median age of 5.5 years, though ages ranged from 2 to 18 years. Survival after initial diagnosis was a median of 12.5 months, with a range of 10 to 28 months, while survival after TARE-Y90 treatment was a median of 4 months, with a range of 2 to 20 months. Three of the 10 patients tolerated retreatment well and also had the longest survival times, ranging from 17 to 20 months. One patient received a transplant 6 weeks after TARE-Y90 treatment.

Using RECIST 1.1 criteria of all target lesions, the majority of patients (8 of 9) had stable disease and 1 of 9 had progressive disease. With mRECIST criteria (requiring postcontrast arterial phase imaging), there was a partial response in 2 of 7 patients, stable disease in 4 of 7 patients, and progressive disease in 1 of 7 patients.

“TARE-Y90 could be considered as adjunctive therapy in pediatric patients with unresectable hepatic malignancies and could be used as a bridge to surgical resection or liver transplant. More research is required to determine the efficacy of this treatment in children and to define the clinical scenarios where benefit is likely to be optimized,” the authors concluded.

Reference

Aguado A, Ristagno R, Towbin AJ, et al. Transarterial radioembolization with yttrium-90 of unresectable primary hepatic malignancy in children. Pediatr Blood Cancer. 2018 Nov 8:e27510. doi: 10.1002/pbc.27510. [Epub ahead of print]