New Jefferson Trial to Test Radiation-Emitting Beads Against Advanced Liver Cancer
Liver
cancer specialists at Jefferson’s Kimmel Cancer Center in Philadelphia
are beginning an 18-month study of a new treatment for liver cancer.
The therapy entails injecting tiny beads that emit small amounts of
radiation into the liver’s main artery while also blocking the blood
supply feeding the cancer’s growth.
The
technique, called radioembolization, has been approved by the federal
Food and Drug Administration for use in inoperable liver cancer. This
is the first time that the particular technology, called SIR-Spheres
microspheres, which is FDA-approved for treating colon cancer that has
spread to the liver, is being studied in patients with hepatocellular
carcinoma, or primary liver cancer (cancer that originates in the
liver). The trial, which is led by Brian Carr, M.D., FRCP, Ph.D.,
professor of Medical Oncology at Jefferson Medical College of Thomas
Jefferson University, includes patients from the University of Texas’
M.D. Anderson Cancer Center in Houston and the University of
Pittsburgh.
According
to Dr. Carr, who is chief of the liver tumor program at the Kimmel
Cancer Center and Thomas Jefferson University Hospital, the technique
uses approximately 30-times more beads than other types or
radioembolization. The teams plan to enroll 10 patients initially, and
perhaps as many as 40 altogether. “No one knows if radioembolization
will be better than just radiation, even though there are theoretical
grounds for it,” he notes.
In
the form of radioembolization being tested, millions of tiny beads or
“microspheres” containing the radioactive isotope Yttrium-90 are
injected through a catheter directly into the liver’s hepatic artery,
which also supplies blood to tumors. The microspheres, in addition to
blocking blood flow to the tumor, emit targeted radiation directly to
the cancer, sparing healthy tissue.
Dr. Carr and his colleagues are encouraged by results from a recent clinical trial showing the effectiveness of a similar
technique against advanced liver cancer. Reporting recently in the journal Hepatology,
Dr. Carr and physicians at Northwestern University in Chicago found
that injecting another type of Yttrium-90-containing beads
(TheraSphere®) was effective in treating inoperable liver cancer even
in patients whose portal vein was blocked by tumor. The treatment, he
says, was as good as or better than using the current standard called
chemoembolization, which involves directly injecting chemotherapy drugs
into the liver through the hepatic artery. Because it involves
dangerous, cell-killing drugs, he notes, doctors have sought liver
cancer treatments that have fewer toxic effects.
The
treatment doesn’t cure the cancer, but has been shown to often shrink
tumors and help patients live longer. It can also be used for patients
who have previously failed chemotherapy. “This extends the numbers of
patients who can be treated with this much safer treatment,” he says.
“Using TheraSphere is just as safe with or without portal vein
thrombosis, so it looks like it’s a wonderful new treatment. It’s much
safer because these patients don’t get chemotherapy side effects, such
as nausea, hair loss and they generally don’t need to be in the
hospital except for the day of treatment, which is usually every three
months.
“The
immediate objective is to get patients to live longer and ultimately, a
cure,” Dr. Carr says. “Right now the choices are surgery and or
transplant. Ideally, if the radioembolization trial is successful, many
of these patients would have their liver tumors shrunken to the point
where surgery is possible. Some may be able to have a transplant. It
would be a significant contribution to the field if we could downstage
the tumors so we could do more transplants, which is the only cure.”
Media Only Contact:
Ed Federico
Thomas Jefferson University Hospital
Phone: (215) 955-6300
Published: 2/11/2008