Selective Internal Radiation Therapy (SIRT) in Patients With Unresectable Colorectal Cancer Liver Metastases Who Failed Prior Intraarterial Pump Chemotherapy

Memorial Sloan Kettering Cancer Center (MSK)

Status and phase: Completed; Phase 1

Conditions: Colon Cancer; Rectal Cancer

Treatments: Device: SIR-spheres® (Selective Internal Radiation Therapy)

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT00972036

09-030

Details and patient eligibility

About

This study is being done with a new therapy called "Selective Internal Radiation Therapy" (known as SIRT). Radiation is an effective treatment for destroying tumors. It is widely used in cancer treatment. However, radiation can harm normal tissue. SIR-Spheres are tiny plastic beads. They contain a radioactive agent called Yttrium-90. These beads can be delivered through a small tube inserted into the blood vessel that goes directly to the tumor. The radiation goes directly to the tumor. This spares healthy parts of your liver.

Enrollment: 32 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Histologic confirmation of colorectal cancer.
• Unequivocal imaging of hepatic metastases.
• Dominant Liver metastases. (Small amount extrahepatic disease allowed.)
• Unresectable liver metastases.
• Liver Metastases non-eligible for, or progressed after ablation
• Failed prior HAC.
• ECOG performance status 0 - 1
• WBC > or = to 1.5 x 109/L
• Platelets > or = to 50 x 109/L
• Creatinine ≤ 1.5 mg/dl
• Bilirubin ≤ 1.5 mg/dl
• Age > or = to 18 years
• Female patients must either be postmenopausal, sterile (surgically or radiation- or chemically-induced), or if sexually active, must agree to use an acceptable method of contraception.
• Male patients must be surgically sterile, or if sexually active, must agree to use an acceptable method of contraception.
• Life expectancy of at least 3 months without any active treatment.
• No chemotherapy regimen administration for at least 4 weeks prior to SIRT administration

Exclusion criteria

• Evidence of severe cirrhosis (CHILDS B and C), portal hypertension with gastroesophageal varices and liver failure as determined by clinical, radiologic or laboratory assessment.

• Previous radiotherapy delivered to the liver.

• Pregnant or breast-feeding.

• Any of the following are contraindications to the use of Yttrium-90 microspheres, and are therefore exclusion criteria:

  • With a Tc-99m macroaggregated albumin (MAA) hepatic arterial perfusion scintigraphy that shows any disposition to the gastrointestinal tract that cannot be corrected by angiographic and embolization techniques.
  • With more than 20% shunting of blood to the lungs as estimated in the Lung Scintigram performed after the intraarterial injection of Tc MAA. Radiation pneumonitis has been seen in patients receiving doses of Yttrium-90 greater than 30 Gy in a single treatment. This corresponds to the shunt over 20% presence of vascular abnormalities, bleeding diathesis, making catheterization of the hepatic artery contraindication.

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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32 participants in 1 patient group

Unresectable colon cancer patients with liver metastases

Experimental group

Description:

This study will be performed to evaluate the safety of Selective Internal Radiation Therapy (SIRT) in patients with liver only colorectal cancer metastases that have received hepatic arterial infusion pump and have progressed through at least one line of chemotherapy.

Treatment:

Device: SIR-spheres® (Selective Internal Radiation Therapy)