RETNET is the first-ever international, randomised controlled trial comparing bland transarterial embolization (TAE), conventional transarterial chembolization (cTACE) with Lipiodol, and TACE using drug-eluting beads (DEB-TACE) for the treatment of neuroendocrine tumour (NET) liver metastases. The drug used in the DEB platform is doxorubicin. Michael Soulen (Philadelphia, USA), who presented the first safety report of the trial, tells CIRSE 2019 delegates that the Data Monitoring and Safety Board has halted the DEB-TACE arm after the first analyses.
“Embolotherapy of NET liver metastases is part of international guidelines, without recommendation regarding technique,” says Soulen, who explains that the patients in the DEB-TACE arm had such a high rate of serious events, that that particular arm of the trial was closed.
Soulen notes that DEB-TACE to explore drugs such as idarubicin or irinotecan may hold some promise, but that DEB-DOX as a platform might need to be “abandoned” for hepatocellular carcinoma and NET treatment. Still, this data is not really a shot in the arm for radioembolization, because that is “its own bowl of wax” with regard to late liver failure due to radiation in long-lived patients, Soulen says.