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Y-90 resin microspheres appear safe for elderly with metastatic CRC

In the MORE clinical trial, the use of SIR-Spheres ytrrium-90 resin microspheres for radioembolization was safe and effective among elderly patients with unresectable liver-dominant metastatic colorectal cancer.

“The analysis of the data from the MORE study confirmed that age alone should not exclude patients from being considered for, or receiving, SIR-Spheres [yttrium]-90 resin microspheres treatment,” Andrew S. Kennedy, MD, director of radiation oncology research, Sarah Cannon Research Institute, Nashville, Tenn., said in a press release. “Because older [metastatic colorectal cancer] patients tend to receive less intense systemic therapy, local liver tumor control with selective internal radiation therapy, or radioembolization, may provide added benefits to this population.”

Kennedy and colleagues assigned 160 elderly patients aged older than 70 years and 446 patients aged younger than 70 years treatment with SIR-Spheres ytrrium-90 resin microspheres (Y-90 resin microspheres, Sirtex) for liver-dominant metastatic colorectal cancer (mCRC). An additional analysis was conducted in 98 very elderly patients (greater than 75 years). All patients who received at least one radioembolization treatment and had at least one follow-up visit were included in the final analyses.

Analyses showed overall survival was similar between elderly and younger patients (9.3 months vs. 9.7 months; P = .335). Very elderly patients and patients aged younger than 75 years also had similar median overall survival (9.3 months vs. 9.6 months; P = .987).

There were no differences between any adverse events (P = .433) or adverse events of grade 3 or more (P = .482) between patients older than 70 years and those aged younger than 70 years. In addition, there were no differences between very elderly patients and patients aged younger than 75 years for any adverse event within 90 days of radioembolization (P = .158).

According to the release, elderly patients were more likely to have liver metastases that did not occur at the same time as their primary tumor (P < .001) or to have undergone previous surgery for their primary tumor (P = .009). Elderly patients also tended to have received fewer lines of chemotherapy treatment (P = .036) and more likely to have experienced a longer period of time between diagnosis and radioembolization (P = .011) compared with the younger patients.

“The current question addressed in this report is the safety and efficacy of liver-directed radiation [Y-90 resin microspheres] delivered intra-arterially and permanently implanted into liver metastases in elderly patients,” the researchers wrote. “Overall, the complimentary and new data reported will enable confidence in offering liver irradiation to patients older than 70 years. These patients are underserved currently, and thus this approach is likely to directly benefit both the quality and quantity of life in elderly patients.” – by Melinda Stevens

Disclosure: Kennedy reports receiving a research grant from Sirtex. Please see the full study for a list of all other authors’ relevant financial disclosures.