FDA Approves Radioembolization Therapy for Liver Cancer

Source: Sirtex Medical

Y-90 resin microspheres (SIR-Spheres) achieved 98.5% overall response rate and 100% local tumor control in unresectable HCC patients, making this the first FDA-approved radioembolization therapy specifically indicated for HCC treatment. This approval provides oncologists with a new locoregional therapy option for Barcelona Clinic Liver Cancer stage A-B2 patients who are not surgical candidates.

Study Design & Population

  • Study type: Multicenter, open-label, single-arm trial (DOORwaY90)
  • Sample size: 100 participants across 18 centers (65 in primary efficacy cohort)
  • Population: Unresectable hepatocellular carcinoma patients
  • Staging: Barcelona Clinic Liver Cancer stage A, B1, or B2

Key Findings

  • Overall response rate: 98.5% with 100% of evaluable patients demonstrating response
  • Local tumor control rate: 100%
  • Duration of response: Median >300 days
  • Safety profile: Most common adverse events (≥10%) included abdominal pain, vomiting, nausea, and fatigue

Clinical Implications

  • First radioembolization therapy with specific FDA indication for unresectable HCC treatment
  • Provides alternative locoregional therapy for patients ineligible for resection or transplantation
  • May be integrated into multidisciplinary treatment algorithms for intermediate-stage HCC
  • Reproducible dosimetry outcomes support standardized treatment protocols

Limitations

  • Single-arm design without direct comparator to standard treatments
  • Relatively small primary efficacy cohort (n=65)
  • Short-term follow-up data; long-term survival outcomes not yet available
  • Safety profile limited to common adverse events without detailed toxicity grading

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