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SIR 2025

Interventional Oncology

Scientific Session

Session: Interventional Oncology - Y90 2

Chemoembolization versus Radioembolization for Breast Cancer Liver Metastasis: Retrospective Multi-Institution Observational Study

Monday, March 31, 2025
3:09 PM – 3:18 PM CT
Location: Music City Center, 208 AB
Purpose: To compare survival after chemoembolization (TACE) versus radioembolization (TARE) combined with immunotherapy or chemotherapy for breast cancer liver metastasis.

Materials and Methods: The multi-institution TriNetX database of anonymized data gleaned from medical records was queried using CPT and ICD-10 codes to identify patients with metastatic breast cancer who underwent TACE or TARE from January 2016 – July 2024. A total of 418 patients were included, with TARE in 334 and TACE in 84. Embolotherapy administration was assessed as following first-, second-, or third-line systemic therapy regimens, and as a combination with either chemotherapy or immunotherapy. Overall survival (OS) probabilities were assessed by Kaplan Meier analysis. Propensity score matching (PSM) analysis accounting for hormone receptor status and line of therapy was used to compare matched cohort of patients who received immunotherapy/TARE to patients who received chemotherapy/TARE, immunotherapy/TACE, and chemotherapy/TACE on survival during the study period.

Results: TARE and TACE patients were similar in age (70 v. 71 y; P=0.287), performance status score (0.9 v. 0.6; P=0.15), and ER+ status (39 v. 35%; P=0.704). TARE patients were less likely to be PR+ (3 v. 12%; P=0.001) and HER2+ (2 v. 12%; P=0.001). Embolotherapy was administered in combination with systemic chemotherapy or immunotherapy in 398 patients, with 64 receiving chemotherapy/TACE, 254 chemotherapy/TACE, 69 immunotherapy/TARE, and 11 immunotherapy/TACE. Embolotherapy was administered after first (n=226), second (n=135), and third (n=37) line therapy with no difference in the distribution of first-, second-, and third-line administration between TARE and TACE groups (P=0.25). Median OS, adjusted by PSM analysis, was significantly longer in patients who received immunotherapy/TARE (38 months), compared to immunotherapy/TACE (36 months; P=0.03), chemotherapy/TARE (33 months; P=0.05), and chemotherapy/TACE (30 months; P=0.04). Three-year survival was highest after immunotherapy/TARE (52%), followed by immunotherapy/TACE (48%), chemotherapy/TARE (45%), and chemotherapy/TACE (40%).

Conclusion: Patients who underwent TARE for breast cancer liver metastasis had better survival compared to patients who underwent TACE. Combining TARE with immunotherapy yielded the best survival rates. Findings suggest further investigation of immunotherapy/TARE combinatorial therapy for breast cancer patients who have failed systemic regimens.