Abstract 157P
Background
REILD is a rare but potentially life-threatening adverse event of Y90-SIRT, with a previously reported incidence of 0-8%. To date, risk factors for REILD remain poorly defined. We aim to define risk factors for REILD in a large cohort of patients treated with Y90-SIRT for HCC from a single institution.
Methods
This is a retrospective study of consecutive patients treated with Y90 for locally advanced HCC from 2007 to 2019 at the National Cancer Centre Singapore and Singapore General Hospital. Excluded were patients lost to follow-up and those with other concomitant cancer. REILD was defined by the presence of ascites and jaundice between 4-8 weeks post-Y90-SIRT in the absence of tumor progression or bile duct obstruction. Patient demographics, clinical history, pertinent laboratory values and radiological findings were collected. Ethical approval was granted by the Institutional Review Board (IRB 2017/2541).
Results
593 patients received Y90 during the study period, of which 472 met the inclusion/exclusion criteria. 12 patients (2.54%) developed REILD. Risk factors for REILD included baseline grade 2 ALBI score (P=0.039), BCLC C HCC (P=0.003), AFP ≥400 pre-Y90 (P=0.005), and radiological ascites (P=0.003). T/N ratio and total administered Y90 dose did not correlate with REILD development. No patients demised from REILD. However, median overall survival (OS) post-Y90 was shorter for REILD patients (22.3 weeks) compared to non-REILD patients (49.1 weeks) (P=0.017). Table: 157P
Baseline characteristics | REILD | Non-REILD | P | |
N = 12 | N = 460 | |||
ALBI grade | 1 | 0 (0.00%) | 130 (28.3%) | 0.039 |
2 | 12 (100%) | 297 (64.6%) | ||
3 | 0 (0.00%) | 33 (7.17%) | ||
BCLC stage | A | 0 (0.00%) | 77 (16.7%) | 0.003 |
B | 0 (0.00%) | 171 (37.2%) | ||
C | 12 (100%) | 208 (45.2%) | ||
D | 0 (0.00%) | 4 (0.87%) | ||
AFP Pre-Y90 | <400 | 2 (20.0%) | 267 (63.9%) | 0.005 |
≥400 | 8 (80.0%) | 151 (36.1%) | ||
NA | 2 | 42 | ||
Radiological ascites | N | 9 (75.0%) | 424 (92.2%) | 0.003 |
Y | 3 (25.0%) | 36 (7.8%) | ||
T/N ratio | Mean (SD) | 3.67 (2.17) | 4.30 (4.14) | 0.369 |
Median (IQR) | 3.46 (2.15-5.37) | 3.12 (2.07-5.31) | ||
Y90 dose (Gbq) | Mean (SD) | 1.73 (1.03) | 1.70 (0.955) | 0.454 |
Median (IQR) | 1.50 (1.33-1.90) | 1.47 (0.980-2.30) |
Conclusions
Risk factors for REILD are varied and multifactorial. HCC stage and underlying liver function are major determinants of REILD risk. The risk of REILD is not dependent on factors related to Y90-SIRT delivery such as median T/N ratio and radiation dose delivered.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
CIRB.
Funding
Has not received any funding.
Disclosure
P. Chow: Financial Interests, Institutional, Advisory Role: Sirtex Medical; Financial Interests, Institutional, Speaker’s Bureau: Sirtex Medical; Financial Interests, Institutional, Research Funding: Sirtex Medical. All other authors have declared no conflicts of interest.
Resources from the same session
571P - Dacomitinib in treatment-naïve EGFR-mutant NSCLC patients with multiple brain metastases: Initial efficacy and safety data from a phase II study
Presenter: Yongfeng Yu
Session: Poster Display
Resources:
Abstract
572P - Multivariable five-year survival prediction model for prognosing patients with EGFR-mutated NSCLC treated with EGFR-TKIs
Presenter: Qi-An Wang
Session: Poster Display
Resources:
Abstract
573P - LUMINATE-103: Real-world treatment patterns and outcomes of patients (pts) with epidermal growth factor receptor mutant (EGFR MU), non-squamous (NSQ) locally advanced/metastatic non-small cell lung cancer (a/mNSCLC): Pooled analysis of large US electronic health record (EHR) datasets
Presenter: Byoung Chul Cho
Session: Poster Display
Resources:
Abstract
574P - Efficacy and safety of dacomitinib in treatment-naïve patients with advanced NSCLC harboring uncommon EGFR mutations
Presenter: Lin Wu
Session: Poster Display
Resources:
Abstract
575P - Efficacy and safety of dacomitinib in treatment-naïve patients with advanced NSCLC and brain metastasis: A multicenter cohort study
Presenter: Puyuan Xing
Session: Poster Display
Resources:
Abstract
576P - Clonality of both EGFR and co-occurring TP53 mutations affect the treatment efficacy of the third-generation EGFR-TKIs in advanced-stage EGFR-mutant non-small cell lung cancer
Presenter: Wen Feng Fang
Session: Poster Display
Resources:
Abstract
577P - A study of the efficacy and safety of amivantamab in EGFR exon 20 insertion (E20I) mutations in NSCLC
Presenter: Daeho Choi
Session: Poster Display
Resources:
Abstract
578P - Tyrosine kinase inhibitor treatment of elderly patients with epidermal growth factor receptor mutated advanced non-small cell lung cancer: A multi-institute retrospective study
Presenter: Ling-Jen Hung
Session: Poster Display
Resources:
Abstract
579P - Real-world study of dacomitinib as first-line treatment for patients with EGFR-mutant non-small cell lung cancer
Presenter: Ji Eun Shin
Session: Poster Display
Resources:
Abstract
580P - Efficacy and safety of dacomitinib as first-line treatment for advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor <italic>(EGFR)</italic> 21L858R mutation: A multicenter, ambispective, consecutive case-series study
Presenter: Shouzheng Wang
Session: Poster Display
Resources:
Abstract