Sequential intra-arterial infusion of 90Y-labeled microspheres and Mitomycin C in chemo refractory liver metastatic breast cancer patients: a single centre pilot study.

  • Brigitte M. Aarts The Netherlands Cancer Institute
  • Elisabeth G. Klompenhouwer The Netherlands Cancer Institute
  • Raphaëla C. Dresen University Hospitals Leuven
  • Christophe M. Deroose University Hospitals Leuven
  • Regina G.H. Beets-Tan The Netherlands Cancer Institute
  • Kevin Punie University Hospitals Leuven
  • Patrick Neven University Hospitals Leuven
  • Hans Wildiers University Hospitals Leuven
  • Geert Maleux University Hospitals Leuven

Abstract

Objectives: To evaluate the safety and feasibility of intra-arterial Mitomycin C (MMC) infusion after radioembolization with microspheres labelled with yttrium-90 (90Y) in liver metastatic breast cancer (LMBC) patients.

Material and Methods: This prospective pilot study included LMBC patients from 2012-2018. Patients first received 90Y, where after response was evaluated by MRI, 18F-FDG PET/CT and laboratory tests. After exclusion of progressive disease, MMC infusion was administered 8 weeks later in different dose cohorts; A: 6mg in 1 cycle, B: 12 mg in 2 cycles, C: 24 mg in 2 cycles and D: maximum of 72 mg in 6 cycles. In cohort D the response was evaluated after every 2 cycles and continued after exclusion of progressive disease. Adverse events (AE) were reported according to CTCAE version 5.0.

Results: Sixteen patients received 90Y treatment. Four patients were excluded for MMC infusion, because of extra hepatic disease progression (n=3) and clinical and biochemical instability (n=1). That resulted in the following number of patient per cohort; A:2 B:1 C:3 and D:6. In 4 of the 12 patients (all cohort D) the maximum dose of MMC was adjusted due biochemical toxicities (n=2) and progressive disease (n=2). One grade 3 AE occurred after 90Y consisting of a gastrointestinal ulcer whereby prolonged hospitalization was needed.

Conclusion: Sequential treatment of intra-arterial infusion of MMC after 90Y was feasible in 75% of the patients when MMC is administered in different escalating dose cohorts. However, caution is needed to prevent reflux after 90Y in LMBC patients.

Author Biographies

Elisabeth G. Klompenhouwer, The Netherlands Cancer Institute

MD PhD

Radiology

Raphaëla C. Dresen, University Hospitals Leuven

Proffessor

MD PhD

Radiology

Christophe M. Deroose, University Hospitals Leuven

Professor 

MD PhD

Nuclear Medicine

Regina G.H. Beets-Tan, The Netherlands Cancer Institute

Professor

MD PhD

Radiology

Kevin Punie, University Hospitals Leuven

Professor

MD PhD

General Medical Oncology

Patrick Neven, University Hospitals Leuven

Professor

MD PhD

General Medical Oncology

Hans Wildiers, University Hospitals Leuven

Professor

MD PhD

General Medical Oncology

Geert Maleux, University Hospitals Leuven

Professor

MD PhD

Radiology

Published
2020-03-25
How to Cite
Aarts, B., Klompenhouwer, E., Dresen, R. C., Deroose, C. M., Beets-Tan, R. G., Punie, K., Neven, P., Wildiers, H., & Maleux, G. (2020). Sequential intra-arterial infusion of 90Y-labeled microspheres and Mitomycin C in chemo refractory liver metastatic breast cancer patients: a single centre pilot study . Radiology and Oncology, 54(1), 33-39. Retrieved from https://www.radioloncol.com/index.php/ro/article/view/3323
Section
Radiology