Feature
EPOCH results: Before and after
Progression-free survival
EPOCH trial investigators announce promising results on role of Y-90 By Hope Racine
T
he recently completed EPOCH trial indicates a promising role for TheraSphere™ yttrium-90 (Y-90) glass microspheres as a
second-line treatment for patients with metastatic colorectal cancer.
According to a 2020 study, colorectal cancer is one of the most common causes of cancer-related death, and an estimated 1.9 million patients are diagnosed with it each year. Of these patients, approximately one-third develop metastases in the liver, which is commonly treated via surgery and traditional chemotherapy.1
effective tool in achieving progression- free survival (PFS) and hepatic progression-free survival (hPFS) in this patient demographic.
The EPOCH
investigators sought to explore whether Y-90 microspheres could be an
12 IRQ | WINTER 2022
“We knew it was unlikely that Y-90 would have a major impact on patients in the first-line setting,” said Riad Salem, MD, MBA, FSIR, the co-principal investigator of the trial. “But once you progress on first-line chemotherapy, you’re in a bit of dire straights and need a way to augment that therapy. That’s why we believed that the second-line setting was a great place to investigate Y-90.”
Dr. Salem and the other investigators agreed that, in the second-line setting,
PFS was the optimal endpoint and determined the patient selection accordingly. Patients enrolled in the trial were those who were progressing on first-line systemic therapy. They excluded those with chemotherapy intolerance, because of the patients’ likely intolerance to additional treatments, and selected patients with good performance status or liver function. Eligible patients were randomized, with half receiving only
At a glance
• The EPOCH trial shows that TheraSphere Y-90 is an effective second-line option for metastatic colorectal cancer.
• Investigators achieved the primary endpoints of progression-free survival and hepatic progression-free survival.
• Y-90 microspheres may be ideal for patients seeking a chemotherapy holiday.
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