Background. When associated with isolated four or fewer liver foci, metastatic
colorectal cancer is amenable to surgical resection. Alternative therapeutic methods for isolated liver
metastases include radioembolization with
yttrium 90 (Y90) and transarterial chemoembolization (TACE). We present here a case of a patient with two sites of liver metastatic disease from
colorectal cancer who underwent Y90 radioembolization combined with
aflibercept and FOLFIRI. Case Report. A 56-year-old female with history of bilateral
breast cancer and metastatic
colon cancer with prior
hemicolectomy and 4 previous
chemotherapy regimens developed liver
metastasis. She was started on
aflibercept and FOLFIRI and concurrently underwent two treatments of radioembolization with Y90, initially targeting the largest right lobe
tumor, and then a subsequent treatment targeting the smaller left lobe
tumor with
retreatment of the right lobe
tumor. Her liver
metastases exhibited partial response on imaging utilizing the modified RECIST criteria. Interestingly, the patient CEA levels decreased after the procedure. Discussion. This is the first reported case of a patient managed with radioembolization with Y90 combined with
aflibercept, an anti-
VEGF treatment, and FOLFIRI. An ongoing randomized clinical trial aims to define the role of combined targeted
therapy and
chemotherapy with radioembolization with Y90.