Radioembolization for Metastatic Neuroendocrine Tumors

Abstract

Transarterial radioembolization (TARE) using β-emitting yttrium-90 microspheres has been used for decades in patients with liver-dominant unresectable metastatic neuroendocrine tumors (mNETs). TARE is one of the embolotherapies supported by the National Comprehensive Cancer Network, among other guidelines, for progressive or symptomatic liver-dominant mNETs. Initial studies with relatively short-term follow-up have indicated that TARE is likely to be at least as effective in controlling symptoms and/or disease progression in the liver as bland or chemoembolization. However, more recent data have shed new light on the risk of long-term hepatotoxicity in patients with mNETs treated with TARE. In this article, we will discuss rationale for TARE, clinical indications, outcomes, and toxicity, as well as new strategies to enhance efficacy of TARE while reducing its toxicity in the treatment of liver-dominant mNETs.