Comparing Survival Outcomes and Toxicities of Y90 Radioembolization of Colorectal Cancer Metastatic to the Liver Between Patients Older and Younger than 70: Analysis from the RESiN Registry (NCT02685631)

Monday, March 6, 2023

4:12 PM – 4:21 PM

Location: Phoenix Convention Center, 224AB

Presenting Author(s)

Steven Bishay, B.S.

Medical Student
Vanderbilt University School of Medicine

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

Erica Emmons, M.D.

Resident
Department of Interventional Radiology, Vanderbilt University Medical Center
LD

Liping Du, Ph.D.

Biostatistician
Biostatistics, Vanderbilt University Medical Center
HK

Henry Krebs, M.D.

Attending Physician
Department of Interventional Radiology, Cancer Treatment Centers of America
Ripal T. Gandhi, M.D.

Attending Physician
Miami Cardiac & Vascular Institute
ZC

Zachary S. Collins, M.D.

Attending Physician
Department of Interventional Radiology, University of Kansas
RO

Ryan O'Hara, M.D.

Attending Physician
University of Utah/Huntsman Cancer Center
NA

Nabeel M. Akhter, M.D.

Attending Physician
Department of Interventional Radiology, University of Maryland
EW

Eric A. Wang, M.D.

Attending Physician
Department of Interventional Radiology, Carolinas Medical Center
CG

Christopher J. Grilli, DO

Attending Physician
Christiana Care
JB

Jayson S. Brower, M.D.

Attending Physician
Department of Interventional Radiology, Providence Sacred Heart
SP

Shannon R. Peck, M.D.

Attending Physician
Department of Interventional Radiology, Sanford Health
MP

Michael Petroziello, M.D.

Attending Physician
Department of Interventional Radiology, Roswell Park Memorial Institute
Ahmed K. Abdel Aal, M.D.

Professor
UT Houston
JG

Jafar Golzarian, MD

Attending Physician
University of Minnesota
Andrew S. Kennedy, M.D.

Attending Physician
Sarah Cannon
Lea Matsuoka, M.D.

Attending Physician
Vanderbilt University Medical Center
DS

Daniel Y. Sze, MD, PhD (he/him/his)

Professor, Editor in Chief
Stanford University; Journal of Vascular and Interventional Radiology
Daniel B. Brown, M.D.

Attending Physician
Vanderbilt University Medical Center

Disclosure(s):

Steven Bishay, B.S.: No financial relationships to disclose

Ripal T. Gandhi, M.D.: ABK Biomedical: Consultant (Ongoing); BD Bard: Consultant (Ongoing); Boston Scientific: Consultant (Ongoing); Cordis: Consultant (Ongoing); Genentech: Speaking and Teaching (Ongoing); Inari medical: Consultant (Ongoing), Speaking and Teaching (Ongoing); Medtronic: Consultant (Ongoing), Speaking and Teaching (Ongoing); Penumbra: Speaking and Teaching (Ongoing); Sirtex Medical: Consultant (Ongoing), Speaking and Teaching (Ongoing); Trisalus Life Sciences: Advisory Committee or Review Panel Member (Ongoing), Speaking and Teaching (Ongoing)

Jafar Golzarian, MD: No relevant disclosure to display

Daniel Y. Sze, MD, PhD: Artio Medical: Consultant (Terminated, January 1, 2021); Astra Zeneca: Consultant (Terminated, January 1, 2021); Bayer: Consultant (Terminated, January 1, 2021); BlackSwan Vascular: Consultant (Terminated, January 1, 2021), Ownership Interest (Terminated, January 1, 2021); Boston Scientific / Biocompatibles BTG: Consultant (Terminated, January 1, 2021), Contracted Research (Terminated, January 1, 2021); Bristol Myers Squibb: Consultant (Terminated, January 1, 2021); Eisai: Consultant (Terminated, January 1, 2021); FluidX: Consultant (Terminated, January 1, 2021); Guerbet: Consultant (Terminated, January 1, 2021); Koli Medical, Inc.: Consultant (Terminated, January 1, 2021), Ownership Interest (Terminated, January 1, 2021); RadiAction Medical: Consultant (Terminated, January 1, 2021), Ownership Interest (Terminated, January 1, 2021); Sirtex Medical: Consultant (Terminated, January 1, 2021), Contracted Research (Terminated, January 1, 2021); Terumo: Consultant (Terminated, January 1, 2021); Trisalus Life Sciences: Consultant (Terminated, January 1, 2021), Ownership Interest (Terminated, January 1, 2021); Varian: Consultant (Terminated, January 1, 2021); W. L. Gore: Consultant (Terminated, January 1, 2021)

Purpose: To compare the clinical presentation, safety and efficacy of ⁹⁰Y resin microspheres for colorectal liver metastases between patients ≥70 years of age versus < 70 from a prospective, multicenter, observational registry.

Materials and Methods: A total of 504 patients were treated: 119 (23.6%) >70 (median age 76.6) and 385 (76.4%) were < 70 years old (median age 55.5). Baseline characteristics are listed in the Table. Overall survival (OS) and progression-free survival (PFS) were assessed using Kaplan-Meier analysis by subgroups and by lines of chemotherapy. Imaging response was assessed with RECIST 1.1 comparing objective response (sum of complete and partial responses) and disease control (objective response plus stable disease). Toxicities were assessed using Common Terminology Criteria for Adverse Events v5.

Results:

The >70 Group had more patients with Eastern Cooperative Oncology Group (ECOG) performance status scores >2 (p=0.002), higher baseline bilirubin (p=0.02) and lower baseline albumin (p=0.01). Ten of 111 (9%) patients in the >70 group were chemotherapy-naive compared to 9/365 of the < 70 group (2%) (p=0.002). Median OS for >70 was 14.9 months [95% confidence interval (CI): 8.2 - 23.8)] vs 15.3 months for < 70 (95% CI: 13.2-17.4) (X²=0.3 and p = 0.6). Median PFS for >70 was 6.1 months (95% CI: 4.5-7.9) vs 7.5 months (95% CI: 6.8 - 9.5) for < 70 (X²= 0.1 and p = 0.7). Median OS and Median PFS by line of therapy were similar for both groups (all p >0.05). Disease control was achieved in 43/65 (66%) patients >70 vs 151/221 (59%) < 70 (p=0.8). Six-month toxicities were available in 380 (75.4%) patients. Grade 3 or greater toxicities occurred in 3/87 (3%) patients >70 and 21/293 (7%) patients < 70 (p=0.7).

Conclusion: Patients ≥70 years old had similar median OS, imaging response and toxicity rates compared with < 70 following ⁹⁰Y radioembolization despite worse baseline performance status, and more patients being chemotherapy-naive.