Management of metastatic colorectal cancer (mCRC) of the liver presents a complex challenge to oncologists and multidisciplinary treatment teams. Selective internal radiation therapy (SIRT) with SIR-Spheres® Y-90 resin microspheres administered by interventional radiologists is an approved local therapy for the management of mCRC liver tumours. Over 100,000 doses have been administered in more than 1300 treatment centres worldwide.

In addition, new data from an array of large, multi-centre, international studies support expanded use of SIR-Spheres Y-90 resin microspheres in appropriate patients.

In first-line treatment of mCRC, a post hoc analysis from two RCTs, SIRFLOX and FOXFIRE Global, indicates that the addition of SIR-Spheres Y-90 resin microspheres to chemotherapy in patients with the primary tumour originating from the right-side of the colon, significantly increases the overall survival (OS). These data were presented at European Society for Medical Oncology (ESMO) World Congress on Gastrointestinal Cancer (WCGIC), 2017.

Furthermore, a retrospective analysis (REsect) of data from the first-line SIRFLOX study demonstrated a significant increase in potential resection of liver metastases when SIR-Spheres Y-90 resin microspheres were added to chemotherapy. The data from the REsect study were presented at the 12th International Congress of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA), May 2017.

Clinical studies in refractory mCRC have shown that SIR-Spheres Y-90 resin microspheres increase the time to progression and prolong overall survival.1-3 In first-line treatment in mCRC, adding SIR-Spheres Y-90 resin microspheres to FOLFOX-based chemotherapy did not diminish patients' quality of life.4,5

Beyond first-line treatment in mCRC, radioembolisation with SIR-Spheres Y-90 resin microspheres has demonstrated a clinically significant benefit in overall survival in multiple clinical studies, leading to the recommendation of SIRT with SIR-Spheres Y-90 resin microspheres by the ESMO and the NCCN clinical practice guidelines for colon cancer.

In Hepatocellular Carcinoma (HCC), results from SARAH and SIRveNIB studies were presented at the 2017 European Association for the Study of the Liver (EASL) International Liver Congress and at 2017 American Society of Clinical Oncology (ASCO) meeting respectively. Results from the SORAMIC study are expected for 2018.

1. Hendlisz et al. J Clin Oncol 2010; 28: 3687–94.
2. Seidensticker et al. Cardiovasc Interv Radiol 2012; 35; 1066‒73.
3. Bester et al. J Vasc Interv Radiol 2012; 23: 96–105.
4. Van Hazel G et al. J Clin Oncol 2016; 34: 1723–1731.
5. Wasan HS et al. Lancet Oncol 2017; 18: 1159-71.

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