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Factors affecting outcomes of Yttrium-90 radioembolization in heavily pretreated patients with intrahepatic cholangiocarcinoma

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

Transarterial radioembolization (TARE) is a liver-directed treatment for unresectable intrahepatic cholangiocarcinoma (ICC). The aim of this study is to evaluate factors affecting outcomes of TARE in heavily pretreated ICC patients.

Methods

We evaluated pretreated ICC patients who received TARE from January 2013 to December 2021. Prior treatments included systemic therapy, hepatic resection, and liver-directed therapies, including hepatic arterial infusion chemotherapy, external beam radiation, transarterial embolization, and thermal ablation. Patients were classified based on history of hepatic resection and genomic status based on next-generation sequencing (NGS). The primary endpoint was overall survival (OS) after TARE.

Results

Fourteen patients with median age 66.1 years (range, 52.4–87.5), 11 females and 3 males, were included. Prior therapies included systemic in 13/14 patients (93%), liver resection in 6/14 (43%), and liver-directed therapy in 6/14 (43%). Median OS was 11.9 months (range, 2.8–81.0). Resected patients had significantly longer median OS compared to unresected patients (16.6 versus 7.9 months; p = 0.038). Prior liver-directed therapy (p = 0.043), largest tumor diameter > 4 cm (p = 0.014), and > 2 hepatic segments involvement (p = 0.001) were associated with worse OS. Nine patients underwent NGS; 3/9 (33.3%) and had a high-risk gene signature (HRGS), defined as alterations in TP53, KRAS, or CDKN2A. Patients with a HRGS had worse median OS (10.0 versus 17.8 months; p = 0.024).

Conclusions

TARE may be used as salvage therapy in heavily treated ICC patients. Presence of a HRGS may predict worse OS after TARE. Further investigation with more patients is recommended to validate these results.

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Funding

This study was supported by NIH/NCI cancer center support grant (Grant No. p30CA008748).

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Authors and Affiliations

  1. Department of Interventional Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Ken Zhao, Joseph P. Erinjeri, Vlasios S. Sotirchos, Erica S. Alexander, Amgad M. Moussa, Brett Marinelli, Etay Ziv, Constantinos T. Sofocleous, Anita Karimi & Hooman Yarmohammadi

  2. Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Ghassan K. Abou-Alfa

  3. Department of Medicine, Weill Medical College at Cornell University, New York, NY, USA

    Ghassan K. Abou-Alfa

  4. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    William R. Jarnagin

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  1. Ken Zhao
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Correspondence to Ken Zhao.

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Zhao, K., Erinjeri, J.P., Sotirchos, V.S. et al. Factors affecting outcomes of Yttrium-90 radioembolization in heavily pretreated patients with intrahepatic cholangiocarcinoma. Abdom Radiol 48, 2434–2442 (2023). https://doi.org/10.1007/s00261-023-03930-0

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