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Interventional Liver-Directed Therapy for Neuroendocrine Metastases: Current Status and Future Directions

  • Neuroendocrine Cancers (JR Strosberg, Section Editor)
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Opinion statement

Liver-directed therapy should be considered for patients with unresectable liver metastases from neuroendocrine tumor if symptomatic or progressing despite medical management. Our experience and current literature shows that the bland embolization, chemoembolization, and radioembolization are very effective in controlling symptoms and disease burden in the liver, and that these embolization modalities are similar in terms of efficacy and radiologic response. Their safety profiles differ, however, with recent studies suggesting an increase in biliary toxicity with drug-eluting bead chemoembolization over conventional chemoembolization, and a risk of long-term hepatotoxicity with radioembolization. For this reason, we tailor the type of embolotherapy to each patient according to their clinical status, symptoms, degree of tumor burden, histologic grade, and life expectancy. We do not recommend a “one-size-fits-all” approach. Our general strategy is to use bland embolization as first-line embolotherapy, and radioembolization for patients with high-grade tumors or who have failed other embolotherapy.

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Authors and Affiliations

  1. Department of Radiology, Division of Vascular and Interventional Radiology, University of Minnesota, 420 Delaware Street SE, MMC 292, Minneapolis, MN, 55455, USA

    Donna D’Souza MBBS, MMed, Jafar Golzarian MD & Shamar Young MD

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  1. Donna D’Souza MBBS, MMed
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  2. Jafar Golzarian MD
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Correspondence to Donna D’Souza MBBS, MMed.

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Donna D’Souza has received compensation from Sirtex and Medtronic for service as a consultant; Jafar Golzarian declares that he has no conflict of interest; Shamar Young has received compensation from Boston Scientific/BTG/Galil Medical for service as a consultant.

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All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

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D’Souza, D., Golzarian, J. & Young, S. Interventional Liver-Directed Therapy for Neuroendocrine Metastases: Current Status and Future Directions. Curr. Treat. Options in Oncol. 21, 52 (2020). https://doi.org/10.1007/s11864-020-00751-x

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