Dr. Salem on the Utility of Y-90 Glass Microspheres in CRC

Riad Salem, MD, vice chair for Image Guided Therapy, Department of Radiology, chief of Vascular and Interventional Radiology, the Department of Radiology, professor of Radiology (Vascular and Interventional Radiology), Medicine (Hematology and Oncology), and Surgery (Organ Transplantation) at the Feinberg School of Medicine, discusses the history of TheraSphere™ Yttrium-90 (Y-90) in metastatic colorectal cancer (CRC).

Historically, Y-90 has been used for patients with CRC in the salvage setting after progression on chemotherapy, Salem explains. Several phase 2 clinical trials have examined the efficacy and safety of the agent in this space. Data with Y-90 demonstrated response rates of approximately 30% to 40% in patients with CRC and median overall survival (OS) of 12 to 14 months depending on the amount of prior chemotherapy a patient received, Salem explains. However, with newer agents emerging for the treatment of patients with CRC, patients are receiving more chemotherapy prior to the salvage setting and progressively longer delays have been seen regarding the use of Y-90, Salem adds.

Studies such as the SIRFLOX (NCT00724503) and the phase 3 FOXFIREGlobal (NCT01721954)trials, evaluated Y-90 as first-line treatment for patients with CRC, but failed to demonstrate an overall survival benefit with the agent, Salem says. As such, Y-90 remains a salvage option for patients who have no other available options, Salem concludes.

^{CAUTION: In the US Therasphere is under and investigational device exemption for treatment of patients with metastatic colorectal cancer. The safety and effectiveness for this treatment has not been established.}