187 - Transarterial Radioembolization (TARE) with Yttrium-90 (Y90) Glass Microspheres in Patients with Large Hepatocellular Carcinoma Tumors: Real-World Data from PROACTIF

Monday, April 13, 2026

4:21 PM - 4:30 PM ET

Presenting Author(s)

Etienne Garin, MD, PhD

Nuclear Medicine Physician
Université De Rennes 1/CRLCC Eugène Marquis, France

Author/Co-author(s)

BG

Boris Guiu, MD, PhD

Chair, Radiology
St-Eloi University Hospital – Montpellier School of Medicine, France
TG

Tlili Ghoufrane, MD

Nuclear Medicine
CHU de Bordeaux, Hôpital Haut-Lévêque, France
CB

Clément Bailly, MD, PhD

Professor
Centre Hospitalier Universitaire de Nantes, France
EV

Eric Vibert, MD, PhD

Professor
Hôpital Paul Brousse, France
JC

Julia Chalaye, MD, PhD

not attending
Henry Mondor Hospital, France
DM

Denis Mariano Goulart, MD

Nuclear Medicine
Centre Hospitalier Universitaire de Montpellier, France
JE

Julien Edeline, MD, PhD

Medical Oncologist
Centre Eugène Marquis, France
JB

Jean-Frederic Blanc, MD, PhD

Medical Oncology
CHU Bordeaux - Hopital St. André, France
YT

Yann Touchefeu, MD, PhD

Medical Oncology
CHU du Nantes - Hôtel-Dieu, France
GG

Gilles Grimon, MD

Nuclear Medicine
Bicetre Hôpital, France
HR

Helène Regnault, MD

Professor
Hôpital Henri Mondor Créteil, France
CS

Christian Sengel, MD

Professor
CHU Grenoble, France
AB

Antoine Bouvier, MD

Département de radiologie
University Hospital, CHU Angers, France
IB

Isabelle Brenot-Rossi, MD

Professor
Institut Paoli-Calmettes, France
GS

Geraldine Sergent, MD

Service Radiologie
Hôpital Claude Huriez du CHU de Lille, France
SR

Stephane Renaud, MD

Nuclear Medicine
Centre Hospitalier de Perpignan - Hôpital Saint Jean, France
SM

Sylvain Manfredi, MD, PhD

Professor
CHU Dijon, France
AD

Arnaud Dieudonnée, PhD

Professor
Centre Henri Becquerel Rouen, France
EV

Eric Vicault, MD

Professor
Hopital Fernand Widal, France

Purpose: Effective treatment of large HCC tumors can be challenging with TARE. Treatment challenges often include tumor dose limitations due to lung shunt fraction and hepatic reserve. We report here patients’ characteristics and outcomes of HCC population according to tumor size from PROACTIF, a multicenter, post-approval Y90 (TheraSphere™) study conducted in 34 French institutions.

Materials and Methods: Index lesion (IL) size was determined by mRECIST assessed by central read in 989 HCC patients and categorized as: ≤5 vs >5 cm; ≤7 vs >7 cm; ≤10 vs >10 cm, with tumors >5 cm categorized as large. Overall survival (OS) was assessed by Kaplan-Meier analysis.

Results: At baseline patients with larger IL were more often older, with a solitary lesion, higher tumor burden, and no previous treatment; other characteristics were similar to the full population including PVT. Overall, median IL size was 6.8 cm [IQR, 4.6 – 9.0 cm]; 294 (31.8%) were ≤5 cm; 517 (55.9%) ≤7 cm and 764 (82.6%) ≤10 cm. Thus, 631 (68.2%) were >5 cm; 408 (44.1%) >7 cm; and 161 (17.4%) >10 cm. The impact of IL size on dose and survival are reported in the table below. Of note, the mean pre/post treatment absorbed dose (AD) to IL decreased with increasing tumor size that may have impacted survival. Ongoing analysis of PROACTIF will investigate factors beyond IL dose that influence median OS. Larger IL size did not limit subsequent surgery nor subsequent treatment.

Conclusion: Real world data demonstrated the ability to deliver a high dose to large tumors, with long OS post treatment in patients with advanced disease. Tumor size did not affect downstaging to surgery or the ability to undergo subsequent treatment.