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. 2023 Jan;50(2):328-343.
doi: 10.1007/s00259-022-05956-w. Epub 2022 Sep 17.

Clinical, dosimetric, and reporting considerations for Y-90 glass microspheres in hepatocellular carcinoma: updated 2022 recommendations from an international multidisciplinary working group

Riad Salem  1 , Siddharth A Padia  2 , Marnix Lam  3 , Carlo Chiesa  4 , Paul Haste  5 , Bruno Sangro  6 , Beau Toskich  7 , Kirk Fowers  8 , Joseph M Herman  9 , S Cheenu Kappadath  10 , Thomas Leung  11 , Daniel Y Sze  12 , Edward Kim  13 , Etienne Garin  14
Affiliations

Clinical, dosimetric, and reporting considerations for Y-90 glass microspheres in hepatocellular carcinoma: updated 2022 recommendations from an international multidisciplinary working group

Riad Salem et al. Eur J Nucl Med Mol Imaging. 2023 Jan.

Abstract

Purpose: In light of recently published clinical reports and trials, the TheraSphere Global Dosimetry Steering Committee (DSC) reconvened to review new data and to update previously published clinical and dosimetric recommendations for the treatment of hepatocellular carcinoma (HCC).

Methods: The TheraSphere Global DSC is comprised of health care providers across multiple disciplines involved in the treatment of HCC with yttrium-90 (Y-90) glass microsphere-based transarterial radioembolization (TARE). Literature published between January 2019 and September 2021 was reviewed, discussed, and adjudicated by the Delphi method. Recommendations included in this updated document incorporate both the results of the literature review and the expert opinion and experience of members of the committee.

Results: Committee discussion and consensus led to the expansion of recommendations to apply to five common clinical scenarios in patients with HCC to support more individualized efficacious treatment with Y-90 glass microspheres. Existing clinical scenarios were updated to reflect recent developments in dosimetry approaches and broader treatment paradigms evolving for patients presenting with HCC.

Conclusion: Updated consensus recommendations are provided to guide clinical and dosimetric approaches for the use of Y-90 glass microsphere TARE in HCC, accounting for disease presentation, tumor biology, and treatment intent.

Keywords: Dosimetry; Hepatocellular carcinoma; Radioembolization; Yttrium-90.

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Conflict of interest statement

Riad Salem is a consultant for Boston Scientific, AstraZeneca, Genentech, Sirtex, Cook, Eisai, Bard, and QED Therapeutics.

Siddharth Padia is a consultant for Boston Scientific Corporation, Teleflex Medical, Guerbet, Varian Medical Systems, and Johnson and Johnson.

Marnix Lam is a consultant for Boston Scientific, Terumo, and Quirem, and he receives research support from Boston Scientific, Terumo, Quirem, and Novartis.

Carlo Chiesa is a consultant for Terumo and Boston Scientific, and he received a research grant in 2017 from the latter company.

Paul Haste is a consultant for Boston Scientific.

Bruno Sangro received consulting fees from Adaptimmune, Astra-Zeneca, Bayer, BMS, Boston Scientific, Eisai, Exelixis, Eli-Lilly, IPSEN, Merck, Onxeo, Roche, Sirtex, and Terumo; lecture fees from Astra-Zeneca, Bayer, BMS, Eisai, Eli-Lilly, Incyte, IPSEN, Roche, and Sirtex; and institutional research grants from BMS and Sirtex.

Beau Toskich is a consultant for AstraZeneca, Genentech, Eisai, Boston Scientific, Sitrex Medical, Turnstone Biologics, Johnson and Johnson, HistoSonics, and VIVOS.

Kirk Fowers is an employee of Boston Scientific Corporation.

Joseph M. Herman is a consultant for Boston Scientific and HistoSonics and received institutional support for the Canopy Cancer Collective Learning Health Network.

S. Cheenu Kappadath has been a consultant for Boston Scientific, Sirtex Medical, ABK Biomedical, and Terumo Medical.

Thomas Leung is a consultant for Boston Scientific, SIRTEX, AstraZeneca, Eisai, and Ipsen.

Daniel Y. Sze was a consultant for Argon, Artio Medical, Astra-Zeneca, Bayer, BlackSwan Vascular, Boston Scientific, Bristol-Myers Squibb, Eisai, FluidX, W. L. Gore, Guerbet, Koli, RadiAction, Sirtex, Terumo, TriSalus Life Sciences, and Varian; received institutional research support from Boston Scientific, Merit Medical, and Sirtex; and serves on Independent Data Safety Monitoring Boards for W. L. Gore and Replimune.

Edward Kim is an advisory board member, speaker, and consultant for Boston Scientific; a consultant for Bristol-Myers Squibb; and an advisory board member for Genentech and Eisai.

Etienne Garin is a consultant for Boston Scientific.

References

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