My concern is the SIRT OS is 2 months worse than SOR. The p value doesn't mean the results are equivalent. The study was statistically powered to show a >4 month benefit for SIRT. There would be insufficient patient numbers to show a lesser difference in effect. There isn't even a trend towards better OS for SIRT, which would help show non-inferiority with reasonable certainty.
The benefit of SOR over placebo is only about 3 months. If this trial had been SIRT vs placebo my bet is the finding would have been no treatment benefit. I agree that the study confirms that SIRT is less toxic and can shrink tumours, but it doesn't show that SIRT will prolong life. I can't see much increased uptake based on these results. My only hope is that SIRveNIB has a more proactive approach to resection or transplant which may yield better results.
On the mCRC front, note that response and PFS were better with SIRT in HCC, but this didn't yield a better OS than systemic therapy. Really hoping the liver PFS result ends up being clinically meaningful.
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