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Semin intervent Radiol 2021; 38(04): 472-478
DOI: 10.1055/s-0041-1735572
Review Article

Radioembolization in the Setting of Systemic Therapies

Tarub S. Mabud
1   Division of Vascular Interventional Radiology, Department of Radiology, NYU Langone Health, New York, New York
,
Ryan Hickey
1   Division of Vascular Interventional Radiology, Department of Radiology, NYU Langone Health, New York, New York
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Abstract

90Yttrium (Y90) radioembolization has been shown to improve outcomes for primary and metastatic liver cancers, but there is limited understanding of the optimal timing and safety of combining systemic therapies with Y90 treatment. Both therapeutic effects and toxicities could be synergistic depending on the timing and dosing of different coadministration paradigms. In particular, patients with liver-only or liver-dominant metastatic disease progression are often on systemic therapy when referred to interventional radiology for consideration of Y90 treatment. Interventional radiologists are frequently asked to offer insight into whether or not to hold systemic therapy, and for how long, prior to and following transarterial therapy. This study reviews the current evidence regarding the timing and safety of systemic therapy with Y90 treatment for hepatocellular carcinoma, metastatic colorectal carcinoma, intrahepatic cholangiocarcinoma, metastatic neuroendocrine tumors, and other hepatic metastases. A particular focus is placed on the timing, dosing, and toxicities of combined therapy.

Keywords

Y90 - radioembolization - systemic therapy - hepatocellular carcinoma - colorectal cancer - cholangiocarcinoma - neuroendocrine tumors - immunotherapy - chemotherapy - interventional radiology

Author Disclosures

R.H. is a consultant for Boston Scientific, Medtronic, and Merck & Co.




Publication History

Article published online:
07 October 2021

© 2021. Thieme. All rights reserved.

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