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Arterial Embolization Using Microspheres for Hypervascular Liver Metastases Refractory to Standard Treatments: A
Masashi Shimohira1, Yozo Sato2, Taku Yasumoto3
1Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, Japan. mshimohira@gmail.com.
Purpose:
To evaluate the clinical utility of bland arterial embolization using microspheres in patients with hypervascular liver metastases refractory to standard treatments.
Materials And Methods:
Primary endpoints of this prospective single-arm non-comparative study were objective response and disease control rates (ORR and DCR), based on the modified Response Evaluation Criteria in Solid Tumors at 4 weeks after embolization. Secondary endpoints were ORR according to primary tumor, overall survival, progression-free survival (PFS), and safety.
Results:
Twenty-five patients with a median age of 66 years (range, 40-95 years) were enrolled in this study. The median maximum diameter of liver metastasis was 3.7 cm (range, 2.0-15.2 cm). Primary lesions were colorectal cancer in 12 patients (48%, 12/25), other cancer in 7 (28%, 7/25), neuroendocrine tumor in 4 (16%, 4/25), and sarcoma in 2 (8%, 2/25). ORR and DCR were 52% (13/25) and 72% (18/25) in all patients, 42% (5/12) and 75% (9/12) in colorectal cancer patients, and 62% (8/13) and 69% (9/13) in other malignant tumor patients (p = 0.43, p > 0.99). Median survival time was 19 months in all patients, 19 months in colorectal cancer patients, and 8 months (p = 0.16) in other malignant tumor patients. Median PFS time was 4 months in all patients, 4 months in colorectal cancer patients, and 6 months (p = 0.0085) in other malignant tumor patients. There were no grade-3 or -4 adverse events.
Conclusion:
Microsphere embolization appears to be an effective and safe treatment for hypervascular liver metastases refractory to standard treatments.
Insights
Bland arterial embolization using microspheres is an effective treatment for hypervascular liver metastases resistant to standard therapies. This study found good response and disease control rates with no severe adverse events.
Area of Science:
- Interventional Radiology
- Oncology
- Hepatology
Background:
- Hypervascular liver metastases often present challenges in treatment, especially when refractory to standard therapies.
- Bland arterial embolization is an emerging therapeutic option for managing liver tumors.
Purpose of the Study:
- To assess the clinical effectiveness and safety of bland arterial embolization with microspheres for patients with hypervascular liver metastases.
- To determine objective response rates (ORR), disease control rates (DCR), overall survival, and progression-free survival (PFS).
Main Methods:
- Prospective, single-arm, non-comparative study involving 25 patients with advanced hypervascular liver metastases.
- Bland arterial embolization using microspheres was performed.
- Response was evaluated using modified Response Evaluation Criteria in Solid Tumors (mRECIST) at 4 weeks post-embolization.
Main Results:
- The objective response rate (ORR) was 52% and the disease control rate (DCR) was 72% across all patients.
- Median overall survival was 19 months, and median progression-free survival (PFS) was 4 months.
- No grade-3 or -4 adverse events were reported, indicating a favorable safety profile.
Conclusions:
- Bland arterial embolization with microspheres demonstrates significant clinical utility as a safe and effective treatment option for hypervascular liver metastases.
- This minimally invasive procedure offers a promising alternative for patients with refractory disease, improving outcomes without substantial toxicity.
