Circulating Nucleosomes in Cancer Patients with Liver Metastases Undergoing Selective Internal Radiation Therapy Using Yttrium-90 Labelled Microspheres

Abstract

Selective internal radiation therapy (SIRT) is a new and effective loco regional anticancer treatment option for advanced cancer patients with liver metastases or liver cancer. In a prospective study, blood samples were taken from 112 patients with extensive hepatic metastases from various primary tumors (49 colorectal, 22 breast, 15 cholangiocellular and pancreatic, 7 carcinoid, 13 others) or with primary hepatic cancer (n = 6) before, and 3, 6, 24 and 48 h after SIRT. Circulating nucleosomes were determined by ELISA and the patterns of nucleosome release in the different groups of primary cancers were compared. Serum nucleosomes showed significant increases already 24 h after SIRT (p < 0.001) and remained high after 48 h (p < 0.001). Those early increases were observed in all patient groups irrespective of the various primary tumors. However, they started from different pre-therapeutic absolute nucleosome levels that may reflect diverse biological properties of the various tumor diseases. Circulating nucleosomes are increased early after application of SIRT. Their relevance for prediction of therapy response and estimation of prognosis has to be shown in prospective studies.