Transarterial Embolization with Small-Size Particles Loaded with Irinotecan for the Treatment of Colorectal Liver Metastases: Results of the MIRACLE III Study

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Abstract

Purpose: This pilot study was performed to investigate safety and local tumor control following transarterial embolization with small-size particles loaded with irinotecan (DEB-IRI) in patients with colorectal liver metastases (CRLM). Materials and Methods: Patients with pretreated CRLM with mono- or bilobar lesions involving less than 60% of the liver parenchyma and Eastern Cooperative Oncology Group performance status 0 or 1 underwent superselective DEB-IRI embolization with 40 µm diameter embolic microspheres. Results: Eighteen patients (11 males, 7 females, median age 61 years) underwent 80 embolization procedures (mean 4.4, range 2–12 per patient). No serious adverse events were reported within 30 days. A total of 39 treatment-related AEs occurred across all embolization procedures. No G4 or G5 treatment-related AEs occurred. Local tumor control, defined as complete response, partial response, or stable disease, was achieved in 16/18 (88.9%), 7/17 (41.2%), and 3/17 (17.6%) patients at 3, 6, and 12 months, respectively. Median liver progression-free survival was 5.9 months (range 27–409 days), and median overall survival was 13.5 months. Conclusion: In this small series, DEB-IRI embolization with small beads was demonstrated a safe procedure in the treatment of patients with CRLM. The promising results in terms of liver-specific progression-free survival and overall survival reported deserve further confirmation in larger prospective trials. Level of Evidence: Level 4, case series.

Original languageEnglish
Pages (from-to)1708-1715
Number of pages8
JournalCardioVascular and Interventional Radiology
Volume41
Issue number11
DOIs
Publication statusPublished - Nov 1 2018

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irinotecan
Particle Size
Neoplasm Metastasis
Liver
Disease-Free Survival
Therapeutics
Survival
Microspheres
Neoplasms

Keywords

  • Colorectal liver metastases
  • Irinotecan
  • Particles
  • Survival
  • Transarterial chemoembolization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{9ffb650396074040829690c5438c2f86,
title = "Transarterial Embolization with Small-Size Particles Loaded with Irinotecan for the Treatment of Colorectal Liver Metastases: Results of the MIRACLE III Study",
abstract = "Purpose: This pilot study was performed to investigate safety and local tumor control following transarterial embolization with small-size particles loaded with irinotecan (DEB-IRI) in patients with colorectal liver metastases (CRLM). Materials and Methods: Patients with pretreated CRLM with mono- or bilobar lesions involving less than 60{\%} of the liver parenchyma and Eastern Cooperative Oncology Group performance status 0 or 1 underwent superselective DEB-IRI embolization with 40 µm diameter embolic microspheres. Results: Eighteen patients (11 males, 7 females, median age 61 years) underwent 80 embolization procedures (mean 4.4, range 2–12 per patient). No serious adverse events were reported within 30 days. A total of 39 treatment-related AEs occurred across all embolization procedures. No G4 or G5 treatment-related AEs occurred. Local tumor control, defined as complete response, partial response, or stable disease, was achieved in 16/18 (88.9{\%}), 7/17 (41.2{\%}), and 3/17 (17.6{\%}) patients at 3, 6, and 12 months, respectively. Median liver progression-free survival was 5.9 months (range 27–409 days), and median overall survival was 13.5 months. Conclusion: In this small series, DEB-IRI embolization with small beads was demonstrated a safe procedure in the treatment of patients with CRLM. The promising results in terms of liver-specific progression-free survival and overall survival reported deserve further confirmation in larger prospective trials. Level of Evidence: Level 4, case series.",
keywords = "Colorectal liver metastases, Irinotecan, Particles, Survival, Transarterial chemoembolization",
author = "Giovanni Mauri and Varano, {Gianluca Maria} and {Della Vigna}, Paolo and Guido Bonomo and Lorenzo Monfardini and Zampino, {Maria Giulia} and Ravenda, {Paola Simona} and Franco Orsi",
year = "2018",
month = "11",
day = "1",
doi = "10.1007/s00270-018-2017-x",
language = "English",
volume = "41",
pages = "1708--1715",
journal = "CardioVascular and Interventional Radiology",
issn = "7415-5101",
publisher = "Springer Verlag",
number = "11",

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TY - JOUR

T1 - Transarterial Embolization with Small-Size Particles Loaded with Irinotecan for the Treatment of Colorectal Liver Metastases

T2 - Results of the MIRACLE III Study

AU - Mauri, Giovanni

AU - Varano, Gianluca Maria

AU - Della Vigna, Paolo

AU - Bonomo, Guido

AU - Monfardini, Lorenzo

AU - Zampino, Maria Giulia

AU - Ravenda, Paola Simona

AU - Orsi, Franco

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Purpose: This pilot study was performed to investigate safety and local tumor control following transarterial embolization with small-size particles loaded with irinotecan (DEB-IRI) in patients with colorectal liver metastases (CRLM). Materials and Methods: Patients with pretreated CRLM with mono- or bilobar lesions involving less than 60% of the liver parenchyma and Eastern Cooperative Oncology Group performance status 0 or 1 underwent superselective DEB-IRI embolization with 40 µm diameter embolic microspheres. Results: Eighteen patients (11 males, 7 females, median age 61 years) underwent 80 embolization procedures (mean 4.4, range 2–12 per patient). No serious adverse events were reported within 30 days. A total of 39 treatment-related AEs occurred across all embolization procedures. No G4 or G5 treatment-related AEs occurred. Local tumor control, defined as complete response, partial response, or stable disease, was achieved in 16/18 (88.9%), 7/17 (41.2%), and 3/17 (17.6%) patients at 3, 6, and 12 months, respectively. Median liver progression-free survival was 5.9 months (range 27–409 days), and median overall survival was 13.5 months. Conclusion: In this small series, DEB-IRI embolization with small beads was demonstrated a safe procedure in the treatment of patients with CRLM. The promising results in terms of liver-specific progression-free survival and overall survival reported deserve further confirmation in larger prospective trials. Level of Evidence: Level 4, case series.

AB - Purpose: This pilot study was performed to investigate safety and local tumor control following transarterial embolization with small-size particles loaded with irinotecan (DEB-IRI) in patients with colorectal liver metastases (CRLM). Materials and Methods: Patients with pretreated CRLM with mono- or bilobar lesions involving less than 60% of the liver parenchyma and Eastern Cooperative Oncology Group performance status 0 or 1 underwent superselective DEB-IRI embolization with 40 µm diameter embolic microspheres. Results: Eighteen patients (11 males, 7 females, median age 61 years) underwent 80 embolization procedures (mean 4.4, range 2–12 per patient). No serious adverse events were reported within 30 days. A total of 39 treatment-related AEs occurred across all embolization procedures. No G4 or G5 treatment-related AEs occurred. Local tumor control, defined as complete response, partial response, or stable disease, was achieved in 16/18 (88.9%), 7/17 (41.2%), and 3/17 (17.6%) patients at 3, 6, and 12 months, respectively. Median liver progression-free survival was 5.9 months (range 27–409 days), and median overall survival was 13.5 months. Conclusion: In this small series, DEB-IRI embolization with small beads was demonstrated a safe procedure in the treatment of patients with CRLM. The promising results in terms of liver-specific progression-free survival and overall survival reported deserve further confirmation in larger prospective trials. Level of Evidence: Level 4, case series.

KW - Colorectal liver metastases

KW - Irinotecan

KW - Particles

KW - Survival

KW - Transarterial chemoembolization

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U2 - 10.1007/s00270-018-2017-x

DO - 10.1007/s00270-018-2017-x

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C2 - 29951693

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VL - 41

SP - 1708

EP - 1715

JO - CardioVascular and Interventional Radiology

JF - CardioVascular and Interventional Radiology

SN - 7415-5101

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