Dr. Marshall on Y-90 Mechanism of Action in Liver-Dominant CRC

John L. Marshall, MD, chief, Division of Hematology and Oncology, Medstar Georgetown University Hospital, discusses the mechanism of action of Yttrium-90 (Y-90) in the treatment of patients with liver-dominant, metastatic colorectal cancer (CRC).

Marshall begins by explaining that the liver is the only organ with 2 "innies." It has an artery and a vein that goes in, and a vein that comes out. The cancer, he says, typically lives on the artery. Oncologists have tackled this particular type of CRC with the use of both catheters and chemoembolization.

Y-90 is a bit different, Marshall explains, as it is injected directly into the tumor and radiates from the inside out. Overall, the treatment is much less toxic, with less pain, nausea, fever, and infection for patients who receive it. Marshall notes that it's best to think of the treatment as low-level chronic radiation, rather than embolism.

He also says that Y-90 may convert some patients to resectable disease due to concomitant liver hypertrophy.