Dr. Mulcahy on Key Takeaways from the EPOCH Trial With TheraSphere Y-90 in CRC

Mary F. Mulcahy, MD, Department of Medicine, Division of Hematology/Oncology, Northwestern University, Lurie Comprehensive Cancer Center, discusses the key takeaways from the ongoing EPOCH trial (NCT01483027) in patients with colorectal cancer (CRC) and liver metastases. 

Multiple prespecified subgroups were investigated on the study to determine which patients would benefit most from the addition of TheraSphere™ Yttrium-90 (Y-90) Glass Microspheres to systemic therapy, according to Mulcahy. Y-90 resulted in promising responses in patients whose tumors harbored KRAS mutations. Because limited treatments are available for this population, further exploration with this modality is warranted, Mulcahy says.

Additionally, patients with intermediate hepatic tumor burden, defined as greater than 10% but less than 25%, as well as those who had fewer than 3 liver lesions and those who had left-sided primary disease were found to derive benefit from the treatment, Mulcahy adds.

During the second line of therapy, it was encouraged that patients receive standard-of-care treatment; however, only 40% of patients who had KRAS wild-type disease received a biologic agent with their second line of treatment, Mulcahy notes. It is possible that if more patients received a biologic agent, there would have been even better outcomes, Mulcahy concludes.