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nivolumab shortly after Y-90 treatment. But be cautious using sorafenib plus Y-90 and combined anti-PD-1/anti-CTLA-4 agents in conjunction with Y-90 due to lack of safety data and outcomes. This is the most common clinical question we encounter in hepatobiliary tumor boards.
What do you consider the impact of these findings? AK: We are hopeful that this report will provide liver-directed treatment teams with increased confidence in using Y-90 in conjunction with systemic agents, as these patients need aggressive therapy to prolong survival, maintain quality of life and avoid uncontrolled tumor growth.
How do you think this research could impact treatment, practice or clinical processes? AK: It is possible that more patients will be offered potentially helpful Y-90 TARE in addition to the exciting new systemic agents. We do not want the benefits of combined modality therapy (Y-90 + systemic) to be underutilized from lack of information, understanding or misplaced concern of excessive toxicities.
What are the next steps? Any additional research planned? AK: Our research collaboration will continue to follow new medical evidence of systemic agents in hepatic cancers, and we may potentially update our report in the future. The current report is an update from a 2017 effort with the same goal.
Mortality, safety, and effectiveness of paclitaxel- containing balloons and stents in the femoropopliteal artery: Systematic review and meta-analysis of randomized controlled trials since 2018
Hayley Briody, MD; Conor Kearns; Michael J. Lee, MD, FRCR, FSIR JVIR. 2024;35(10):1423–1434. This was a JVIR featured article.
Tell us about you, your research team and your institution. Hayley Briody, MD: I am an Irish radiology resident at Beaumont Hospital in Dublin. I did my medical degree with the Royal College of Surgeons in Ireland, graduated in 2020 and am now in my second year of radiology residency. In Ireland, the route to IR is still via diagnostic radiology residency followed by IR fellowship, so I hope to enter the field of IR in this way with a goal of completing my subspecialty IR fellowship in the United States.
Beaumont is an excellent center for IR, with both general and neurointerventional radiology fellowship opportunities, and it is the national thrombectomy center. The IR department values research, and I’ve been fortunate enough to engage in a number of projects, many of which, including this publication, were under the supervision of the exceptional Professor Michael Lee, MD, FRCR, FSIR, who although recently retired, continues to push forward with research in the field of IR.
For this project it was a small team; I led the study under Prof. Lee’s supervision, and had the help of a medical student, Conor Kearns. I think it’s important to involve medical students in research. I was given the opportunity when I was a medical student at RCSI to get involved in a project with a radiology resident in Beaumont at the time, and I really valued the experience. It gave me an insight into radiology, the training scheme in Ireland and helped forge connections for my career in radiology. I was keen to get a medical student involved in the hope they would have the same experience and perhaps even consider a career in IR. I met Conor through RCSI, and he was very enthusiastic. I knew he would bring focus and be an asset to the project.
What was the focus on your study? HB: The safety of paclitaxel-containing balloons and stents in femoropopliteal arterial disease was drawn into question in 2018. Katsanos et al. published a meta-analysis, which concluded a higher mortality rate with these devices when compared with plain old balloon angioplasty or bare metal stenting. As a result, the use of paclitaxel drug-eluting therapies declined across the world. I noted in my institution that they’re not used in this region at all. In the aftermath of the 2018 meta-analysis, longer-term patient level data of initial trials and more modern studies were published, attempting to disprove this increased mortality signal. Our study focused on pooling all of these publications to determine if the mortality risk persisted with modern data and whether we should continue to avoid or reconsider using paclitaxel drug-eluting therapy in this region.
Read the full article on
jvir.org. 26 IRQ | FALL 2024
What prompted you to look into paclitaxel use specifically? HB: As a diagnostic radiology resident interested in pursuing a career in IR, I wanted to undertake a research project with an IR focus. So, I approached Prof. Lee, who thankfully always has a list of ideas ready to go, and he gave me this one. I was drawn to the study because I thought it highlighted the fast-paced nature of IR and how the rapid evolution of techniques and devices can often
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