Grant: Collaborative Health Research Projects (NSERC partnered)

"The Canadian Cancer Society reports that the incidence of primary liver cancer (hepatocellular carcinoma) is on the rise, with 1,700 cases, and 700 associated deaths in 2010. In addition, secondary liver cancer, with the most common form being metastatic colorectal carcinoma, is also on the rise in Canada, with 22,000 new cases and 9,100 associated deaths in 2010. For patients with liver cancer or metastases that are unsuitable for surgery, radioembolization becomes a viable, effective and safe treatment. In this treatment, radioactive microspheres are directly administered into the hepatic artery which provides the hepatic tumours with 80-100% of their blood supply. The microspheres become trapped in the small blood vessels of the tumour vasculature where they irradiate the tumour. Radioembolization is currently performed with two different types of microspheres loaded with Y-90 (SIRspheres from Sirtex, Australia; and Theraspheres from Nordion, Canada). This approach demonstrates significant response, but possesses inherent limitations. Our project addresses them all. We propose (1) to use a new type of microspheres which are biodegradable, monosized and cheap, and (2) to replace Y-90 by Re-188 which has beta emissions almost identical to Y-90 and also emits 155 keV gammas allowing for quantitative imaging and accurate patient-specific dosimetry. Additionally,Re-188 can be conveniently obtained from a W-188/Re-188 generator. Our microspheres loaded with Tc-99m will be used for shunt assessment and therapy planning, then loaded with Re-188 in patient-specific activity concentrations. Accordingly, the number and size of microspheres will be adjusted for each patient. In the scope of this project we will develop the necessary therapy platform that includes automated Re-188 radiolabelling, dosing, quantification and imaging. To reach the aim of providing Canadian liver tumour patients with this improved second generation radioembolization therapy."