Combining Y90 Transarterial Radioembolization With Immunotherapy is Safe
Yttrium-90 (90Y) transarterial radioembolization (TARE) around immunotherapy is safe and effective and the combined treatment may improve hepatic progression-free survival (hPFS) and overall survival (OS) in patients with hepatic metastases from uveal melanoma (UM), according to a new study published in the Journal of Vascular and Interventional Radiology.
In this study, the researchers aimed to evaluate the safety and efficacy of yttrium-90 (90Y) TARE around immunotherapy. Eleven patients with unresectable hepatic metastases from UM were treated with TARE around immunotherapy from March 2013 to December 2017. Two patients received TARE as a first-line treatment followed by immunotherapy and 9 patients received immunotherapy before receiving TARE. Of the 9 patients received immunotherapy first, 6 received additional immunotherapy after TARE. The median follow-up from TARE was 10.5 months.
A retrospective review of the clinical data assessed hPFS and OS. From the time of diagnosis of hepatic metastases and from the start of TARE, the median OS was 35.5 months (95% confidence interval [CI] 10.0-55.0 months) and 17 months (95% CI 1.8-32.2 months), respectively. The median hPFS from the start of TARE was 15.0 months (95% CI 5.9-24.1 months). Complete response was observed in 1 patient (9.1%), partial response in 2 (18.2%), stable disease in 4 (36.4%), and progressive disease in 4 (36.4%).
A total of 10 patients had grade 1 or 2 clinical toxicities and 1 patient had grade 3 toxicities. Grade 1 or 2 biochemical toxicities were present in 6 patients. Grade 3 biochemical toxicities were present in 1 patient, which was found to be related to tumor progression.
“The preliminary results of the present study showed that TARE around immunotherapy achieved a longer survival time for patients with hepatic metastases from UM...However, the data on combined treatment remain limited, and many questions, such as types of cancer targeted for treatment, combination schedule and sequence of radiotherapy and checkpoint blockades, etc, require additional investigations. Therefore, additional clinical studies are necessary to confirm the preliminary results presented here,” the authors concluded.
Zheng J, Irani Z, Lawrence D, Flaherty K, Arellano RS. Combined Effects of Yttrium-90 Transarterial Radioembolization around Immunotherapy for Hepatic Metastases from Uveal Melanoma: A Preliminary Retrospective Case Series. J Vasc Interv Radiol. Aug 2018 . pii: S1051-0443(18)31164-3. doi: 10.1016/j.jvir.2018.04.030. [Epub ahead of print].