Dr. Jeyarajah on SIR-Spheres® Y-90 Resin Microspheres as Maintenance in CRC With Liver Metastases

Rohan Jeyarajah, MD, hepatopancreaticobiliary surgeon, Methodist Richardson Medical Center, discusses the potential role of SIR-Spheres^® Y-90 resin microspheres from Sirtex Medical in colorectal cancer (CRC) with liver metastases.

Although the data with maintenance therapy in CRC with liver metastases are inconclusive, the general goal of maintenance treatment is to de-escalate chemotherapy, Jeyarajah explains. For example, a patient could receive full-dose FOLFOX chemotherapy for 12 cycles but de-escalate to 5-fluorouracil plus a biologic agent in the maintenance setting if they have small volume disease to optimize quality of life (QOL).

Y-90 resin may be utilized in patients with liver-predominant disease to further improve QOL and eliminate the need for chemotherapy completely in the maintenance setting, Jeyarajah says. However, if patients have other sites of disease like lung metastases or retroperitoneal lymphadenopathy, chemotherapy should be continued as maintenance.

Ultimately, Y-90 resin may have a role as maintenance therapy in patients with liver-predominant disease to control liver disease with minimal toxicity, Jeyarajah concludes.