Ann: Becoming a substantial holder-SRX.AX, page-26

My summary:

• The key recommendation is for using SIRT in the salvage setting, in this setting SIRT receives the second strongest recommendation (level B recommendation, meaning it is ‘generally recommended’, on a scale of A to E).
• The guidelines note that the clinical evidence relates to SIR-Spheres (resin microspheres) as opposed to Theraspheres (glass microspheres)
• Flagged the liver PFS benefit in SIRFLOX as ‘potentially relevant’, and stated that the data suggests liver-only patients will receive the most benefit.
• Suggests SIRT can be used as an alternative to surgery in patients that would not have enough healthy liver left if they had surgery.
• Suggests that SIRT could act as a ‘consolidation treatment’ (ie in between 1^st and 2^nd line chemo) but that this early line use should be limited to clinical trials.

These 2016 guidelines represent a step up in the level of discussion and recommendation given to SIRT as compared to the 2014 ESMO guidelines, which simply read: “In patients with liver-limited metastases failing the available chemotherapeutic options, radioembolisation with yttrium-90 resin microspheres can also prolong the time to tumour progression [IV, B].”