Grant: Collaborative Health Research Projects

The Canadian Cancer Society reports that the incidence of primary liver cancer (hepatocellular carcinoma) ison the rise, with 1,700 cases, and 700 associated deaths in 2010. In addition, secondary liver cancer, with themost common form being metastatic colorectal carcinoma, is also on the rise in Canada, with 22,000 new casesand 9,100 associated deaths in 2010.For patients with liver cancer or metastases that are unsuitable for surgery, radioembolization becomes aviable, effective and safe treatment. In this treatment, radioactive microspheres are directly administered intothe hepatic artery which provides the hepatic tumours with 80-100% of their blood supply. The microspheresbecome 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 demonstratessignificant 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-90and 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 loadedwith Tc-99m will be used for shunt assessment and therapy planning, then loaded with Re-188 inpatient-specific activity concentrations. Accordingly, the number and size of microspheres will be adjusted foreach patient. In the scope of this project we will develop the necessary therapy platform that includesautomated Re-188 radiolabelling, dosing, quantification and imaging. To reach the aim of providing Canadianliver tumour patients with this improved second generation radioembolization therapy.