Ho-RadioEmbolizaTiOn Using personalized prediCtive dosimetry in patients with Hepatocellular carcinoma: A prospective, single-centre study (RETOUCH).

Background And Aims: Holmium-166 (Ho) radioembolization could offer a more individualized approach in terms of imaging and dosimetry. We aim to evaluate the feasibility and safety of Ho selective internal radiation therapy (SIRT) using a higher tumour dose than previously administered determined by Ho-scout as a surrogate marker in HCC patients.

Methods: This is an open-label, prospective, non-randomized, single-centre pilot study that included patients with HCC that received Ho-SIRT if the work-up using Ho-scout showed a tumour-absorbed dose ≥150 Gy, a non-tumoural liver absorbed dose less than 60 Gy and a lung absorbed dose less than 30 Gy.

Long-Term Outcomes of Balloon TACE for HCC: An European Multicentre Single-Arm Retrospective Study.

Purpose: To report response rates (using mRECIST), overall survival (OS), progression-free survival and local tumour recurrence-free survival (LRFS) of balloon-occluded transarterial chemoembolisation (bTACE) for hepatocellular carcinoma (HCC).

Materials And Methods: Patients from five European centres treated with conventional or drug-eluting microsphere bTACE for HCC were included, and patients already lost to follow-up before 12 months were excluded. Possible factors contributing to LRFS and OS were evaluated with Cox proportional hazards models.

Endoscopic submucosal dissection for rectal neuroendocrine tumours: A multicentric retrospective study.

Introduction: Endoscopic Submucosal Dissection (ESD) has been reported as a feasible and effective treatment for Rectal Neuroendocrine Tumours (R-NETs). However, most of the experience on the topic comes from retrospective tertiary centre from Eastern Asia. Data on ESD for R-NETs in Western centres are lacking.

Local triamcinolone injection and selective add-on oral steroids to prevent esophageal post-endoscopic submucosal dissection stricture: a retrospective analysis in a Western center.

Background: Extensive esophageal endoscopic submucosal dissections (ESDs) without preventive measures carry a high risk of stricture. Oral steroids and local injection of triamcinolone acetonide have proven to be effective in Asia for the prevention of esophageal stricture. This study aimed to assess the efficacy of a systematic steroid administration protocol for stricture prevention in a Western center.

Impact of scatter correction on personalized dosimetry in selective internal radiotherapy using Ho-PLLA: a single-center study including Monte-Carlo simulation, phantom and patient imaging.

Background: Developments in transarterial radioembolization led to the conception of new microspheres loaded with holmium-166 (Ho). However, due to the complexity of the scatter components in Ho single photon emission computed tomography (SPECT), questions about image quality and dosimetry are emerging. The aims of this work are to investigate the scatter components and correction methods to propose a suitable solution, and to evaluate the impact on image quality and dosimetry including Monte-Carlo (MC) simulations, phantom, and patient data.

Clinical impact of Tc-MAA SPECT/CT-based personalized predictive dosimetry in selective internal radiotherapy: a real-life single-center experience in unresectable HCC patients.

Background: Recent data demonstrated that personalized dosimetry-based selective internal radiotherapy (SIRT) is associated with better outcome for unresectable hepatocellular carcinoma (HCC).

Aim: We aim to evaluate the contribution of personalized predictive dosimetry (performed with Simplicity® software) in our population of HCC patients by comparing them to our historical cohort whose activity was determined by standard dosimetry.

Methods: This is a retrospective, single-center study conducted between February 2016 and December 2020 that included patients with HCC who received SIRT after simulation based on either standard dosimetry (group A) or, as of December 2017, on personalized dosimetry (group B).

Duodenal Hemorrhage Due to an Invasive Hepatocellular Carcinoma Controlled by Transarterial Embolization.

Upper gastrointestinal (GI) bleeding due to duodenal invasion is a very unusual presentation revealing the initial diagnosis of hepatocellular carcinoma (HCC), especially in patients without cirrhosis. No clear recommendations are available in this setting. A 68-year-old man was admitted to the emergency department with melena.

Real-life multi-center retrospective analysis on nivolumab in difficult-to-treat patients with advanced hepatocellular carcinoma.

Background: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death worldwide. The landscape of the systemic treatment for advanced HCC is changing quickly, and recently, the standard of care became either atezolizumab plus bevacizumab or tremelimumab plus durvalumab in the single tremelimumab regular interval durvalumab regimen. Nivolumab monotherapy has proven to be effective sometimes for advanced HCC and could be a valuable treatment option for patients outside current treatment indications and reimbursement criteria for the standard of care.

Comparison of PMT-based TF64 and SiPM-based Vereos PET/CT systems for Y imaging and dosimetry optimization: A quantitative study.

Background: Selective internal radiotherapy based on transarterial radioembolization (TARE) with yttrium-90 ( Y) microspheres is an established treatment for primary or metastatic liver disease.

Purpose: The objective of this work is to optimize the dosimetry of patients treated with Y TARE, using positron emission tomography (PET) images.

Methods: The NEMA 2012 PET phantom was filled with nearly 3.

The path to personalized treatment in advanced and metastatic biliary tract cancers: a review of new targeted therapies and immunotherapy.

Purpose Of Review: To summarize targeted therapies and immunotherapy as treatment for advanced/metastatic biliary tract cancers and discuss ongoing clinical trials.

Recent Findings: For the first time since gemcitabine-cisplatin was set as the standard of care in first-line advanced/metastatic biliary tract cancers in the ABC-02 trial, the combination of durvalumab and gemcitabine-cisplatin has demonstrated a statistically significant improvement of median overall survival in the TOPAZ-1 phase 3 trial. The ABC-06 trial showed a significant increase of median overall survival for FOLFOX and active symptom control compared with active symptom control alone in second-line regardless of molecular and genetic alterations.

In the Era of Systemic Therapy for Hepatocellular Carcinoma Is Transarterial Chemoembolization Still a Card to Play?

Conventional transarterial embolization (cTACE) has been proven to be effective for intermediate stage hepatocellular carcinoma (HCC), with a recent systematic review showing an overall survival (OS) of 19.4 months. Nevertheless, due to the rapid development of the systemic therapeutic landscape, the place of TACE is becoming questionable.

Balloon-occluded chemoembolization for hepatocellular carcinoma: a prospective study of safety, feasibility and outcomes.

Aim: Evaluation of safety and efficacy of selective balloon-occluded transarterial chemoembolization using polyethylene glycol embolizing microspheres in patients with hepatocellular carcinoma.

Materials & Methods: Twenty-four consecutive patients were included in this monocentric prospective trial. Adverse events were evaluated at 24 h and 1 month.

Endoscopic Full-Thickness Resection of a Colonic Lateral Spreading Tumor.

The Full-Thickness Resection Device (FTRD; Ovesco Endoscopy, Tübingen, Germany) combines endoscopic full-thickness resection (EFTR) of gastrointestinal lesions with closure and cutting of the tissue in one integrated procedure. It provides en-bloc resection with an integral wall specimen for histopathological evaluation. This resection technique is partially filling of the gaps between the current procedures of choice in endoscopy (endoscopic mucosal resection and endoscopic submucosal dissection) and surgery.