The management of Renal cell carcinoma (RCC) patients with liver metastases is challenging. Liver-directed therapy, such as Transarterial radioembolization (TARE), is a reasonable option for these patients; however, its safety and efficacy are not well characterized. This study evaluated the safety and efficacy of TARE in patients with liver-dominant metastatic RCC.
This is a retrospective, single-center study. Thirty-eight patients' medical records were reviewed who underwent TARE between January 1, 2009, and December 31, 2019, in a tertiary cancer center. Two were excluded from further analysis. Thirty-six patients received 51 TARE treatments. Median follow-up time was 18.2 months. Imaging data were evaluated using mRECIST or RECIST 1.1 criteria. Toxicities, treatment responses, liver progression-free survival (LPFS), and median overall survival (OS) were calculated. Univariate and multivariate analyses were conducted to reveal predictors of OS.
Median OS from TARE was 19.3 months (95% CI, 22.6-47.4) and from diagnosis of liver metastases was 36.5 months (95% CI: 26.4-49.8). Mild, grade 1 or 2, biochemical toxicity developed in 27 patients (75%). Grade 3-4 toxicity was noted in two patients (5.5%). The objective response rate was 89%; the disease control rate was 94% (21 complete response, 11 partial response, two stable disease, and two progressive disease). Univariate and multivariate analyses showed longer survival in patients who had objective response, lower lung shunt fraction, and better baseline liver function.
TARE is safe and effective and led to promising overall survival in patients with liver-dominant metastatic RCC.
Level 3, retrospective cohort study.
Cardiovascular and interventional radiology. 2021 Jul 26 [Epub ahead of print]
Andras Bibok, Rahul Mhaskar, Rohit Jain, Jingsong Zhang, Jessica Frakes, Sarah Hoffe, Ghassan El-Haddad, Nainesh Parikh, Altan Ahmed, Mayer N Fishman, Junsung Choi, Bela Kis
Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, USA., Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA., Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA., Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA., Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, USA. .