This phase II trial studies the side effects and how accurate low dose Y90 microspheres works for determining the amount of blood that flows between the liver and the lungs for the purpose of radioembolization (Y90) therapy planning in patients with stage A-C liver cancer. Y90 microspheres are tiny beads filled with a radioactive agent called Y90 that are placed inside the blood vessel that provides blood supply to the tumor. Understanding the amount of blood flow can help researchers obtain an accurate estimation of Y90 radioembolization therapy in the tumor(s), liver and lungs. This is to ensure maximizing tumor response while minimizing the side effects to the normal liver and lungs.
Additional locations may be listed on ClinicalTrials.gov for NCT04172714.
See trial information on ClinicalTrials.gov for a list of participating sites.
PRIMARY OBJECTIVE:
I. To compare the safety and accuracy/efficacy of low dose yttrium Y 90 (Y90) resin microspheres and macroaggregated albumin (MAA) in predicting the actual dose delivered to the tumor, liver, and lung after Y90 therapy.
SECONDARY OBJECTIVES:
I. To identify tumor dose response thresholds (TDRT) and tumor dose distribution in patients with hepatocellular carcinoma (HCC) treated with Y90 resin microspheres.
II. To optimize low dose Y90 techniques in predicting tumor to normal liver activity ration (TNR) and lung shunt fraction (LSF).
OUTLINE:
Patients undergo planning and mapping over 1 week. Patients receive low dose Y90 intra-arterially mapping and then receive therapeutic dose of Y90 intra-arterially for yttrium-90 microsphere radioembolization. Patients also undergo single photon emission computed tomography (SPECT)/computed tomography (CT) on the day of the mapping and 2 positron emission tomography (PET)/CT scans over 30 minutes either on the same day or the day after the planning and therapy respectively. Patients may undergo a second yttrium-90 microsphere radioembolization in 4 weeks if entire tumor is covered by the initial Y90 radioembolization therapy.
After completion of study treatment, patients are followed up at 1, 3, and 6 months and then every 3 months thereafter.
Lead OrganizationEmory University Hospital/Winship Cancer Institute
Principal InvestigatorNima Kokabi