What are SIR-Spheres® Y-90 resin microspheres?

SIR-Spheres Y-90 resin microspheres are microscopic resin beads that contain the radioactive isotope Yttrium-90 (Y-90) and emit radiation to kill cancer cells. Due to their small size (1/3 the width of a human hair) and similar density to blood cells, the microspheres travel easily with the bloodstream directly to the liver tumours. The microspheres become lodged in the vessels supplying the tumour and kill the cancer cells through radiation. Selective Internal Radiation Therapy (SIRT) with SIR-Spheres Y-90 resin microspheres is considered as a well-tolerated and effective method  using radiation to treat primary liver cancer and other types of cancer that has spread to the liver. SIR-Spheres Y-90 resin microspheres are manufactured by Sirtex Medical Limited whith the headquarter in Australia.

What do SIR-Spheres Y-90 resin microspheres treat?

SIR-Spheres Y-90 resin microspheresare approved for the treatment of inoperable liver tumours in Australia, the European Union (CE Mark), Argentina (ANMAT), Brazil, and several countries in Asia, such as Turkey, India and Singapore.

The product is also supplied for this use in countries such as Hong Kong, Israel, Malaysia, New Zealand, Taiwan and Thailand.

SIR-Spheres Y-90 resin microspheres also have a full Pre-Market Approval (PMA) by the FDA and are indicated in the United States for the treatment of nonresectable metastatic liver tumours from primary colorectal cancer in combination with intra-hepatic artery chemotherapy using floxuridine

Can you describe the SIR-Spheres Y-90 resin microspheres procedure?

The SIR-Spheres Y-90 resin microspheres treatment can be performed as an outpatient procedure by specially trained physicians called interventional radiologists. Using the liver's unique blood supply, millions of tiny resin microspheres loaded with Yttrium-90 (Y-90) are released into the liver blood circulation. The radioactive microspheres lodge in the blood supply of the tumour, where they emit radiation for about two weeks.

The treatment normally takes about 60 to 90 minutes. Patients are carefully monitored throughout and after the procedure. The most commonly reported side effects are flu-like symptoms over one to three weeks. The procedure can be performed in combination with chemotherapy or by itself.

Who performs the SIRT procedure?

The SIRT procedure is conducted by a medical team that includes a specialist known as interventional radiologist, together with other specialists trained to work with radiation.

How effective is the treatment?

Clinical studies have shown that SIRT with SIR-Spheres Y-90 resin microspheres increase the length of time that the cancer is stable and not growing without adversely affecting the patient's quality of life. In clinical studies with metastatic colorectal cancer patients, the SIRT procedure has been combined with chemotherapy, given as a single procedure during a chemotherapy holiday or after chemotherapy options have failed.

In hepatocellular carcinoma (HCC), clinical studies showed significantly less adverse events and better quality of life for patients who received SIR-Spheres compared to those who were treated with the standard of care, sorafenib. However, the studies did not show a benefit in overall survival compared to sorafenib.

Who is eligible for treatment with SIR-Spheres Y-90 resin microspheres?

SIRT is only suitable for patients who have liver tumours where either the liver is the only site of disease or the liver is the major site of disease. The treatment offers an option to patients who have liver tumours which cannot be treated by surgical resection or ablation.

Where is the procedure performed?

The procedure is performed at a hospital or clinic by highly trained physicians called interventional radiologists. It can be on an outpatient basis or might require a couple of days of hospitalisation, depending on the local regulations.

How are SIR-Spheres Y-90 resin microspheres delivered?

During the procedure, the interventional radiologist threads a tiny catheter through the large artery in the leg. Then the catheter is advanced into the hepatic artery, which supplies the liver tumour(s) with blood. Once the catheter is in position, millions of microspheres are delivered directly to the tumour site. The SIR-Spheres Y-90 resin microspheres become lodged in the tumour bed and emit radiation to the tumours, while the surrounding healthy liver tissue remains unaffected.

What will happen after I have received SIRT?

Immediately following the SIRT procedure, you may be taken for a scan to confirm that the SIR-Spheres Y-90 resin microspheres have been infused into your liver. You will also be monitored for a few hours after the procedure to enable the treatment team to determine whether you have any side effects or complications that require additional medication.

How are SIR-Spheres Y-90 resin microspheres different from other treatments?

Radiation is an effective therapy which is often used to treat cancer. However, normal liver cells are very sensitive to radiation. The targeted nature of SIR-Spheres Y-90 resin microspheres therapy enables doctors to deliver up to 40 times more radiation to the liver tumours than would be possible using normal external beam radiotherapy, while sparing the surrounding healthy liver tissue from damage.

How common is this procedure?

SIR-Spheres Y-90 resin microspheres are currently being offered at over 1,230 sites in more than 40 countries around the world. Over 92,000 doses of SIR-Spheres Y-90 resin microspheres have been supplied worldwide.

Other than treating the cancer, what are the benefits to the patients?

Besides offering patients an effective treatment option to control the spread of the cancer in their liver, therapy with SIR-Spheres Y-90 resin microspheres also help patients maintain a good quality of life. The procedure can be performed as an outpatient service which minimises the time spent at the hospital or the patient stay few days in the hospitals depending on the local regulations.

Also, this is usually a single treatment therefore requiring less travels for the patients., with usually relatively minimal side effects.

What are the likely side effects?

Almost all treatments and drugs produce unwanted side effects. Most side effects following a SIRT procedure are minor, but a small number can be serious. Many patients experience abdominal pain or tightness in their abdomen, nausea and loss of appetite which normally subsides within a week. Patients may also develop a mild fever that may last for up to a week and fatigue which may last for several weeks.

What are the potential complications?

In rare instances, a small number of microspheres may inadvertently reach other organs in the body, such as the gallbladder, stomach, intestine, or pancreas. If microspheres reach these organs, they can cause inflammation or ulceration. These complications are rare, but if they do occur they will require additional medical treatment.

What should I do if I experience a side effect?

It is important that you contact your doctor or nurse if you experience a side effect. Your doctor might prescribe medications to ease any discomfort.

Will I lose my hair?

Hair loss (alopecia) has never been reported following treatment with SIR-Spheres Y-90 resin microspheres. If you are receiving chemotherapy this may cause hair loss, however SIR-Spheres Y-90 resin microspheres will not make this worse.

Do patients have to take special precautions?

There are some simple precautions that patients need to take during the first 24 hours following the SIRT procedure. These precautions include: thorough hand washing after using the toilet, and cleaning up any spills of body fluids such as blood, urine or stools and disposing of them in the toilet. Otherwise, patients can resume normal contact with family members.

Does insurance cover the procedure?

The insurance coverage is country dependant. You can send a query using our contact form to get more information regarding insurance in your region.

Where can I get treatment with SIR-Spheres Y-90 resin microspheres?

SIR-Spheres Y-90 resin microspheres are currently being offered at over 1,230 sites in more than 40 countries around the world.

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