Radioembolization in Colorectal Cancer with Liver Metastasis

EP: 1.Treatment Options for Colorectal Cancer with Liver Metastasis

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EP: 2.Radioembolization in Colorectal Cancer with Liver Metastasis

EP: 3.The EPOCH Trial: Rationale and Design

EP: 4.The EPOCH Trial: Efficacy and Safety

EP: 5.Implications of the EPOCH Trial in Clinical Practice

Mary F. Mulcahy, MD: Historically, radioembolization for colorectal liver metastases has been used for patients who have progressed on all standard therapies to help control the disease burden in the liver despite them having progressed through all systemic options. The use of radioembolization earlier on in disease, while they still have active systemic chemotherapy, is the area that we’ve been exploring recently. We’ve been able to do that as a result of the advances in our delivery of radioembolization. Radioembolization beads are delivered through the hepatic artery and become embedded in the small vessels of the tumor. We’ve had a lot of advances and gotten much more experience understanding how much radiation can be delivered to a certain lobe, the potential damage to blood vessels, and any hepatic artery injury or hepatic parenchymal injury that can occur as a result of radiation, so we feel confident in safely delivering this therapy.

Therapy can be delivered either into a particular lobe or into the whole liver, depending on the distribution of disease and the underlying liver function. Many of our systemic chemotherapy agents may cause some liver dysfunction. It can cause some steatohepatitis or other damage to the liver parenchyma. This needs to be considered when we’re thinking about adding radiation, such as radioembolization, to the liver. By studying patients who have progressed on therapy, we’ve learned a lot about how to best deliver this treatment. This has informed the study that was recently completed.

Transcript edited for clarity.