Digestive Health

Updated 04 July 2014

Specialised treatment for cancer patients gets nod

Patients with metastatic colorectal cancer and cholangiocarcinoma who may benefit from special therapy could soon be treated in NHS centres.

Specialised NHS centres in the UK will soon offer selective internal radiation therapy (Sirt) to patients with metastatic colorectal cancer and intrahepatic cholangiocarcinoma.

Sirt is a non-surgical procedure in which an interventional radiologist uses a catheter directed through an incision in the patient's femoral artery to deliver a treatment comprising millions of radioactive microspheres (more than 30 million resin microspheres coated in radioactive Yttrium-90 in the case of SIR-Spheres microspheres) directly into branches of the hepatic (liver) artery.

The microspheres are carried by the blood flow through the arteries into the small vessels that nourish tumours in the liver, where they ultimately become trapped due to their size and deliver high doses of beta-radiation directly to the tumours. Because internal radiation is delivered directly to the tumours, patients may receive radiation doses many times greater than possible with external beam radiation.

Difficult months

The consultant oncologist at the Oxford University Hospitals NHS Trust, Dr Ricky Sharma, said: "This announcement is very good news to the large number of patients with liver metastases from colorectal cancer who have previously received chemotherapy and biological treatments, many of whom have been waiting for several difficult months in anticipation of this announcement.

"It is also excellent news for patients with cholangiocarcinoma, a rare and aggressive form of liver cancer for which there are very few treatments available.

"Enabling suitable patients across the whole of England to have access to Sirt in this important evaluation process represents a significant advance for the NHS."

Additive treatment

Colorectal cancer is the third-most prevalent cancer in the world. It is also a cancer that too often spreads (or metastasizes) to other organs in the body, most commonly the liver.  Despite increased emphasis on colorectal cancer screening, patients who go to doctors often have the first stages of metastatic colorectal cancer.

The NHS statement said Sirt should not routinely be used in the initial treatment of colorectal treatment, for which chemotherapy and biological therapy were the current standards of care.

However, the statement also recommended that eligible colorectal patients be offered enrolment in a UK clinical trial called Foxfire, where SIR-Spheres microspheres were administered in parallel with first-line chemotherapy and biologic agents to determine if an additive treatment benefit exists from first-line use of Sirt.

Changes in diet

It also announced that colorectal patients who were chemo-refractory (no longer responsive to chemotherapy or biological therapy) might be offered Sirt at NHS specialist centres, or encouraged to enrol in other Sirt clinical trials if applicable.

Intrahepatic cholangiocarcinoma is a cancer that arises in the epithelium or wall of the liver's bile ducts. It is a relatively rare cancer that is becoming somewhat more common, suggesting that occurrence may be linked to changes in diet or lifestyle.

The NHS said that few proven treatments exist for this disease and recommended that Sirt could be offered to chemo-refractory patients at NHS specialist centres.

For further information: Downloadable images, background information, a mode-of-action video and further supporting materials are available online at http://www.SIRTnewsroom.com. http://www.sirtex.com

Press release from Sirtex Medical Europe

Photo: Radiation therapy from Shutterstock


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Dr. Estelle Wilken is a Senior Specialist in Internal Medicine and Gastroenterology at Tygerberg Hospital. She obtained her MBChB in 1976, her MMed (Int) in 1991 and her gastroenterology registration in 1995.

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