Liver Neoplasms
Conditions
Keywords
Gastrointestinal Diseases, Colonic Diseases, Intestinal Diseases, Rectal Diseases, Neoplastic Processes, Pathologic Processes, Neuroendocrine Tumors, Neuroectodermal Tumors, Neoplasms, Germ Cell and Embryonal, Adenocarcinoma, Neoplasms, Nerve Tissue, Liver Diseases, Neoplasms, Carcinoma, Colorectal Neoplasms, Neoplasm Metastasis, Carcinoma, Neuroendocrine, Liver Neoplasms, Neoplasms, Glandular and Epithelial, Neoplasms by Histologic Type, Intestinal Neoplasms, Gastrointestinal Neoplasms, Digestive System Neoplasms, Neoplasms by Site, Digestive System Diseases
Brief summary
This study is an open label prospective trial of TheraSphere treatment for patients who have liver metastases who have failed or are intolerant to other systemic or liver directed therapies. Patients will be treated with TheraSphere at doses of 120 ± 10% Gy, and then followed for time to progression (TTP), safety, and overall survival.
Interventions
Patients with unilobar disease will receive 120 ± 10% Gy (dose may be lower if clinically indicated) of TheraSphere to the affected lobe. Patients presenting with bilobar disease will have their liver assessed and the lobe presenting the highest treatment priority will receive the first treatment of TheraSphere. Assigning priority of lobes to receive treatment is based on tumor bulk, associated clinical symptoms attributed to the tumor and technical/angiographic considerations. In patients with bilobar disease where the second lobe does not require immediate treatment, or in unilobar disease where tumors develop in the untreated lobe, additional TheraSphere treatment may be administered at any subsequent time. A treatment may consist of a single 120 ± 10% Gy infusion to a lobe, or, if angiography indicates the need, the 120 ± 10% Gy dose may be split into multiple infusions per lobe to ensure delivery of a total of 120 ± 10% Gy to each treated lobe.
Sponsors
Study design
Eligibility
Inclusion criteria
* 18 years of age or older, * Patients with a diagnosis of metastatic disease to the liver who have failed or are intolerant to other systemic or liver directed therapies. A patient is considered to have failed to other systemic or liver-directed therapies when, in the opinion of the referring physician, the patient has progression of disease after receiving standard approved therapies. Specifically, if a patient has failed first line chemotherapy (or the standard approved therapies for that particular solid tumor), in the time period designed to assess that particular regimen (at least 30 days), then they may be enrolled into this protocol. A patient is intolerant to other systemic or liver-directed therapies when, in the opinion of the referring physician, for example, the patient is unable to tolerate appropriate chemotherapy, when the patient had residual toxicity from previous therapies (e.g. neuropathy from oxaliplatin), or when the patient's performance status is such that treatment with systemic therapies would result in excessive toxicity. * Liver metastases are unresectable * Target tumors should be measurable using standard imaging techniques * Tumor replacement ≤ 70% of total liver volume based on visual estimation by the Investigator * Tumors are hypervascular based on visual estimation by the Investigator * Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0-2 * At least one month has elapsed since most recent prior cancer therapy with the following exceptions * Patients who are receiving Sandostatin for treatment of Neuroendocrine cancer may be enrolled and continue their Sandostatin treatment. * Patients receiving anti-oestrogen therapy for breast cancer may continue their treatment if therapy was initiated greater than 30 days prior to TheraSphere treatment. * Chemotherapy may continue if there is evidence of progression, in the liver, on treatment providing there is no change in the therapy in the 1 month prior to TheraSphere treatment and any immediate chemotherapeutic toxicity that will complicate TheraSphere treatment is resolved. In this case, the chemotherapy may continue because it is continuing to control the extrahepatic disease. * Patient is willing to participate in the study and has signed the study informed consent
Exclusion criteria
* At risk of hepatic or renal failure, as indicated by any of the following pre-treatment laboratory and clinical findings within 28 days of treatment: * Serum creatinine \> 2.0 mg/dL, unless on dialysis * Serum total bilirubin ≥ 2.0 mg/dL * Albumin \< 2.0 g/dL * Any history of hepatic encephalopathy * Contraindications to angiography and selective visceral catheterization that may include, but are not limited to, the following: * Any bleeding diathesis or coagulopathy that is not correctable by usual therapy or hemostatic agents (e.g., closure device) * Severe peripheral vascular disease precluding catheterization * History of severe allergy or intolerance to contrast agents, narcotics, sedatives or atropine that cannot be managed medically. * Severe liver dysfunction or presentation of pulmonary insufficiency or a clinically evident history of chronic obstructive pulmonary disease * Cirrhosis or portal hypertension * Previous external beam radiation treatment to the liver * Any intervention for, or compromise of the Ampulla of Vater * Clinically evident ascites. (Note: A radiographic finding of trace ascites on imaging is acceptable). * Any continuing complications of prior cancer therapy that have not improved or resolved prior to 21 days before the first treatment with TheraSphere (if the investigator determines that the continuing complication will compromise the safety of the patient following treatment with TheraSphere). * In the judgment of the physician, significant life-threatening extrahepatic disease * Concurrent enrollment in another clinical study * Evidence on technetium-99m macroaggregated albumin (99mTc-MAA) scan that demonstrates lung shunting with a potential absorbed dose of radiation to the lungs \>30 Gy. The 30 Gy limit is a cumulative limit over all infusions of TheraSphere. * Evidence on technetium-99m macroaggregated albumin (99mTc-MAA) scan that demonstrates a potential for the deposition of microspheres to the gastrointestinal tract that cannot be corrected by placement of the catheter distal to collateral vessels or using standard angiographic techniques, such as coil embolization. * A positive serum pregnancy test in women of childbearing potential * In the Investigator's judgment, any co-morbid disease or condition or event (e.g., recent myocardial infarction) that would place the patient at undue risk, and that would preclude safe use of TheraSphere
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to Progression (TTP) of the Treated Lesion(s) According to RECIST Criteria | Evaluated 4 weeks following each TheraSpheres procedure, and at 2-3 month intervals thereafter. | This outcome was not assessed. Instead, the primary outcome of progression-free survival based on RECIST and EASL criteria was assessed and reported. |
| Progression-free Survival (PFS) of the Treated Lesion(s) According to RECIST and EASL Criteria | 2 years | Progression-free survival was defined as the time from the date of Y-90 radioembolization to date of disease progression or latest follow-up. PFS was analyzed via Kaplan-Meier methodology with log-rank test using all 50 patients on study and stratified based on disease type. RECIST and EASL criteria were used to assess progression with kappa value for intermethod agreement of treatment responses of 0.9. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | 12 months | Efficacy as assessed by radiographic tumor response using EASL criteria at baseline up to 12 months post treatment. Complete Response (CR): Achieving 100% tumor necrosis of targeted lesions Partial Response (PR): Demonstrating greater than 50% tumor necrosis in targeted lesions Progressive Disease (PD): Reappearance of or increased tumor enhancement greater than 25% in targeted lesions Stable Disease (SD): Not meeting requirements for CR or PR and not demonstrating evidence of progression in targeted lesions. |
| Overall Survival (OS) | Median follow-up time was 11.41 months (CI: 1.5-33.7) | Measured from the date corresponding to initiation of therapy until the date of death due to any cause. At the time of registration, the outcome measure was entered in clinicaltrials.gov as open-ended. Overall survival was analyzed via Kaplan-Meier methodology with log-rank test using all 50 patients on study and stratified based on disease type. |
| Time to Progression (TTP) of the Treated Lesion(s) According to EASL Criteria | Evaluated 4 weeks following each TheraSpheres procedure, and at 2-3 month intervals thereafter. | This outcome was not assessed. Instead, the primary outcome of progression-free survival based on RECIST and EASL criteria was assessed and reported. |
| Safety as Graded by CTCAE Version 3.0 | 12 months | Clinical and biochemical toxicity that were assessed as at least possibly related to treatment were recorded from the day of treatment until protocol exit or death. Toxicities were graded by the Common Terminology Criteria for Adverse Events (CTCAE) v3.0. |
| Mean Radiation Dose Delivered to Total Liver | 24 hours | Therasphere dose calculation was performed using positron emission tomography-computed tomography (PET/CT) and single-photon emission computed tomography (SPECT) imaging post-procedure to estimate the actual delivered dose of Theraspheres to the liver. |
| Overall Survival (OS) Rate at 2 Years | Up to 2 years | Measured from the date corresponding to initiation of therapy until the date of death due to any cause. At the time of registration, the outcome measure was entered in clinicaltrials.gov as open-ended. At the time of results reporting, this outcome was presented as Up to 2 years. Overall survival was analyzed via Kaplan-Meier methodology with log-rank test using all 50 patients on study and stratified based on disease type. 2-year OS rates were also stratified based on tumor burden. |
| Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.0 | 12 months | Efficacy as assessed by radiographic tumor response using RECIST criteria at baseline, at 4 weeks post treatment, and subsequent 3 month intervals. Complete Response (CR): Disappearance of all lesions targeted by Y90 Partial Response (PR): At least 30% decrease in the sum of longest diameter (LD) of lesions targeted by Y90 Progressive Disease (PD): At least 20% increase in sum of LD of lesions targeted by Y90 Stable Disease (SD): Neither sufficient shrinkage for PR nor sufficient increase for PD. |
Countries
United States
Participant flow
Recruitment details
This study enrolled patients diagnosed with unresectable hepatic metastases who have failed or were intolerant to at least one line of systemic chemotherapy or liver-directed therapy. Participants were enrolled at Johns Hopkins Hospital with the last patient completed in April 2015.
Participants by arm
| Arm | Count |
|---|---|
| TheraSphere TheraSphere, Yttrium-90 glass Microspheres: Patients with unilobar disease will receive 120 ± 10% Gy (dose may be lower if clinically indicated) of TheraSphere to the affected lobe. Patients presenting with bilobar disease will have their liver assessed and the lobe presenting the highest treatment priority will receive the first treatment of TheraSphere. Assigning priority of lobes to receive treatment is based on tumor bulk, associated clinical symptoms attributed to the tumor and technical/angiographic considerations. In patients with bilobar disease where the second lobe does not require immediate treatment, or in unilobar disease where tumors develop in the untreated lobe, additional TheraSphere treatment may be administered at any subsequent time | 50 |
| Total | 50 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Change in treatment modality | 21 |
| Overall Study | Death | 4 |
| Overall Study | Entered hospice care | 5 |
| Overall Study | Lost to Follow-up | 2 |
| Overall Study | Required additional Y90 treatment | 6 |
Baseline characteristics
| Characteristic | TheraSphere |
|---|---|
| Age, Continuous | 59.3 years |
| Region of Enrollment United States | 50 Participants |
| Sex: Female, Male Female | 19 Participants |
| Sex: Female, Male Male | 31 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 4 / 50 |
| other Total, other adverse events | 48 / 50 |
| serious Total, serious adverse events | 14 / 50 |
Outcome results
Progression-free Survival (PFS) of the Treated Lesion(s) According to RECIST and EASL Criteria
Progression-free survival was defined as the time from the date of Y-90 radioembolization to date of disease progression or latest follow-up. PFS was analyzed via Kaplan-Meier methodology with log-rank test using all 50 patients on study and stratified based on disease type. RECIST and EASL criteria were used to assess progression with kappa value for intermethod agreement of treatment responses of 0.9.
Time frame: 2 years
Population: Median PFS for all subjects and stratified based on disease type.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| TheraSphere | Progression-free Survival (PFS) of the Treated Lesion(s) According to RECIST and EASL Criteria | Median PFS for all disease types | 10.3 months |
| TheraSphere | Progression-free Survival (PFS) of the Treated Lesion(s) According to RECIST and EASL Criteria | Median PFS for CRC | 22.0 months |
| TheraSphere | Progression-free Survival (PFS) of the Treated Lesion(s) According to RECIST and EASL Criteria | Median PFS for NE | 9.5 months |
| TheraSphere | Progression-free Survival (PFS) of the Treated Lesion(s) According to RECIST and EASL Criteria | Median PFS for non-CRC/non-NE | 15.8 months |
Time to Progression (TTP) of the Treated Lesion(s) According to RECIST Criteria
This outcome was not assessed. Instead, the primary outcome of progression-free survival based on RECIST and EASL criteria was assessed and reported.
Time frame: Evaluated 4 weeks following each TheraSpheres procedure, and at 2-3 month intervals thereafter.
Population: These data were not collected. See outcome measure #2.
Mean Radiation Dose Delivered to Total Liver
Therasphere dose calculation was performed using positron emission tomography-computed tomography (PET/CT) and single-photon emission computed tomography (SPECT) imaging post-procedure to estimate the actual delivered dose of Theraspheres to the liver.
Time frame: 24 hours
Population: Mean radiation doses were calculated for the total cohort of participants and also stratified according to disease type - colorectal cancer, neuroendocrine, and non-CRC/non-NE.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| TheraSphere | Mean Radiation Dose Delivered to Total Liver | Mean dosing for non-CRC/non-NE | 115.18 Gray | Standard Deviation 16.37 |
| TheraSphere | Mean Radiation Dose Delivered to Total Liver | Mean radiation dose for all patients | 112.13 Gray | Standard Deviation 13.56 |
| TheraSphere | Mean Radiation Dose Delivered to Total Liver | Mean dosing for CRC | 115.57 Gray | Standard Deviation 10.97 |
| TheraSphere | Mean Radiation Dose Delivered to Total Liver | Mean dosing for NE | 109.41 Gray | Standard Deviation 13.08 |
Overall Survival (OS)
Measured from the date corresponding to initiation of therapy until the date of death due to any cause. At the time of registration, the outcome measure was entered in clinicaltrials.gov as open-ended. Overall survival was analyzed via Kaplan-Meier methodology with log-rank test using all 50 patients on study and stratified based on disease type.
Time frame: Median follow-up time was 11.41 months (CI: 1.5-33.7)
Population: Median OS for all patients (n=50) were analyzed and also stratified based on disease type: CRC (n=12); NE (n=26); and non-CRC/non-NE (n=12).
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| TheraSphere | Overall Survival (OS) | Median OS for all disease types | 11.7 months |
| TheraSphere | Overall Survival (OS) | Median OS for CRC | 11.9 months |
| TheraSphere | Overall Survival (OS) | Median OS for NE | 7.6 months |
| TheraSphere | Overall Survival (OS) | Median OS for non-CRC/non-NE | 15.8 months |
Overall Survival (OS) Rate at 2 Years
Measured from the date corresponding to initiation of therapy until the date of death due to any cause. At the time of registration, the outcome measure was entered in clinicaltrials.gov as open-ended. At the time of results reporting, this outcome was presented as Up to 2 years. Overall survival was analyzed via Kaplan-Meier methodology with log-rank test using all 50 patients on study and stratified based on disease type. 2-year OS rates were also stratified based on tumor burden.
Time frame: Up to 2 years
Population: 2-year OS rate for all patients (n=50) were analyzed and also stratified based on tumor burden: Patients with tumor burden of 25% or less (n=34) and patients with tumor burden greater than 25% (n=16).
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| TheraSphere | Overall Survival (OS) Rate at 2 Years | OS rate for tumor burden 25% or less | 36 percentage of participants |
| TheraSphere | Overall Survival (OS) Rate at 2 Years | OS rate for all patients | 22 percentage of participants |
| TheraSphere | Overall Survival (OS) Rate at 2 Years | OS rate for tumor burden greater than 25% | 0 percentage of participants |
Safety as Graded by CTCAE Version 3.0
Clinical and biochemical toxicity that were assessed as at least possibly related to treatment were recorded from the day of treatment until protocol exit or death. Toxicities were graded by the Common Terminology Criteria for Adverse Events (CTCAE) v3.0.
Time frame: 12 months
Population: 50 participants were assessed for adverse events, with a total of 207 adverse events reported. Two patients had grade 5 toxicities (grade 5 cholecystitis and death), which were attributed to disease progression and were not device-related.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Elevated alkaline phosphatase | 21 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Elevated ALT | 13 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Elevated AST | 11 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Lymphocyte depression (asymptomatic) | 23 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Fatigue | 33 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Fever | 8 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Nausea | 19 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Heartburn | 6 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Vomiting | 6 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Pain | 23 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Decreased albumin | 4 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Elevated bilirubin | 3 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Anorexia | 11 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Weight loss | 13 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Constipation | 7 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Muscle pain | 1 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Cholecystitis | 1 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Death (disease progression) | 1 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Allergic reaction (contrast media) | 1 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Thrombosis/embolism (vascular access) | 1 adverse events |
| TheraSphere | Safety as Graded by CTCAE Version 3.0 | Liver failure | 1 adverse events |
Time to Progression (TTP) of the Treated Lesion(s) According to EASL Criteria
This outcome was not assessed. Instead, the primary outcome of progression-free survival based on RECIST and EASL criteria was assessed and reported.
Time frame: Evaluated 4 weeks following each TheraSpheres procedure, and at 2-3 month intervals thereafter.
Population: Analysis for TTP was not performed. In lieu of TTP, the PFS based on RECIST and EASL criteria was analyzed.
Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.0
Efficacy as assessed by radiographic tumor response using RECIST criteria at baseline, at 4 weeks post treatment, and subsequent 3 month intervals. Complete Response (CR): Disappearance of all lesions targeted by Y90 Partial Response (PR): At least 30% decrease in the sum of longest diameter (LD) of lesions targeted by Y90 Progressive Disease (PD): At least 20% increase in sum of LD of lesions targeted by Y90 Stable Disease (SD): Neither sufficient shrinkage for PR nor sufficient increase for PD.
Time frame: 12 months
Population: RECIST for all applicable patients (n=43) were analyzed and also stratified based on disease type: CRC (n=9); NE (n=22); and non-CRC/non-NE (n=12).
| Arm | Measure | Group | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|---|
| TheraSphere | Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.0 | All disease types | Partial Response (PR) | 9 Participants |
| TheraSphere | Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.0 | All disease types | Complete Response (CR) | 11 Participants |
| TheraSphere | Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.0 | All disease types | Stable Disease (SD) | 11 Participants |
| TheraSphere | Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.0 | All disease types | Progressive Disease (PD) | 12 Participants |
| TheraSphere | Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.0 | Colorectal cancer only | Complete Response (CR) | 1 Participants |
| TheraSphere | Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.0 | Colorectal cancer only | Partial Response (PR) | 3 Participants |
| TheraSphere | Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.0 | Colorectal cancer only | Stable Disease (SD) | 2 Participants |
| TheraSphere | Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.0 | Colorectal cancer only | Progressive Disease (PD) | 3 Participants |
| TheraSphere | Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.0 | Neuroendocrine only | Complete Response (CR) | 7 Participants |
| TheraSphere | Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.0 | Neuroendocrine only | Partial Response (PR) | 4 Participants |
| TheraSphere | Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.0 | Neuroendocrine only | Stable Disease (SD) | 6 Participants |
| TheraSphere | Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.0 | Neuroendocrine only | Progressive Disease (PD) | 5 Participants |
| TheraSphere | Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.0 | Non-CRC/Non-NE | Complete Response (CR) | 3 Participants |
| TheraSphere | Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.0 | Non-CRC/Non-NE | Partial Response (PR) | 2 Participants |
| TheraSphere | Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.0 | Non-CRC/Non-NE | Stable Disease (SD) | 3 Participants |
| TheraSphere | Tumor Response by Response Evaluation Criteria in Solid Tumors (RECIST) v1.0 | Non-CRC/Non-NE | Progressive Disease (PD) | 4 Participants |
Tumor Response by the European Association for the Study of the Liver (EASL) Criteria
Efficacy as assessed by radiographic tumor response using EASL criteria at baseline up to 12 months post treatment. Complete Response (CR): Achieving 100% tumor necrosis of targeted lesions Partial Response (PR): Demonstrating greater than 50% tumor necrosis in targeted lesions Progressive Disease (PD): Reappearance of or increased tumor enhancement greater than 25% in targeted lesions Stable Disease (SD): Not meeting requirements for CR or PR and not demonstrating evidence of progression in targeted lesions.
Time frame: 12 months
Population: RECIST for all applicable patients (n=43) were analyzed and also stratified based on disease type: CRC (n=9); NE (n=22); and non-CRC/non-NE (n=12). 7 out of the 50 patients were not analyzed due to lack of follow-up imaging.
| Arm | Measure | Group | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|---|
| TheraSphere | Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | Colorectal cancer only | Complete Response (CR) | 1 Participants |
| TheraSphere | Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | Colorectal cancer only | Partial Response (PR) | 2 Participants |
| TheraSphere | Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | Colorectal cancer only | Stable Disease (SD) | 3 Participants |
| TheraSphere | Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | Colorectal cancer only | Progressive Disease (PD) | 3 Participants |
| TheraSphere | Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | Neuroendocrine only | Complete Response (CR) | 7 Participants |
| TheraSphere | Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | Neuroendocrine only | Partial Response (PR) | 5 Participants |
| TheraSphere | Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | Neuroendocrine only | Stable Disease (SD) | 4 Participants |
| TheraSphere | Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | Neuroendocrine only | Progressive Disease (PD) | 6 Participants |
| TheraSphere | Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | Non-CRC/Non-NE | Complete Response (CR) | 3 Participants |
| TheraSphere | Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | Non-CRC/Non-NE | Partial Response (PR) | 2 Participants |
| TheraSphere | Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | Non-CRC/Non-NE | Stable Disease (SD) | 3 Participants |
| TheraSphere | Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | Non-CRC/Non-NE | Progressive Disease (PD) | 4 Participants |
| TheraSphere | Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | All disease types | Complete Response (CR) | 11 Participants |
| TheraSphere | Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | All disease types | Partial Response (PR) | 9 Participants |
| TheraSphere | Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | All disease types | Stable Disease (SD) | 10 Participants |
| TheraSphere | Tumor Response by the European Association for the Study of the Liver (EASL) Criteria | All disease types | Progressive Disease (PD) | 13 Participants |