Research on superantigen-based inner interventional radioactive Yttrium-90 for liver cancer

Liver cancer is one of the most common diseases endangering the people's lives and health heavily. Hypoimmunity has been widely supposed as one of the main causes for occurring of liver cancer. In order to induce the local anti-tumor immune response in patients with liver cancer, injection of radioactive Yttrium-90 with superantigen injections by ultrasonically guide has been performed. Superantigen-based radioactive Yttrium-90 therapy appears to be an Option for Liver Cancer. It also appears to be safe and well tolerated in patients with unresectable hepatocellular carcinoma (HCC) and portal vein thrombosis (PVT). The noval therapy has been used as the therapy of choice, which provokes a substantial nonspecific immune cellular activation to target T-cells to the tumor area, to recognize tumor cells, and direct a more specific anti-tumor immune response. Also, in the clinical phase III trial of HAS, the efforts for the observation of effect and prognosis of liver cancer have been made successfully, while the relation between local immune responses in tumor area has been discussed in this trial. This relatively new treatment involves the delivery of superantigen-based Yttrium-90 directly to the tumor by ultrasonically guide. The radioactive beads stick to the tumors where they release pure beta radiation, producing a highly localized effect while sparing normal tissue. The treatment is currently approved in the research for use only in patients with inoperable HCC who have an adequate level of liver function. The aim of the current study was to determine the safety and tolerability of Yttrium-90 in patients with unresectable HCC with compromised portal venous flow in one or both first order and related segmental portal venous branches without evidence of cavernous transformation. Eligible patients were required to be volunteers in this clinical phase III trial and to have a histologic diagnosis of liver cancer, which include hepatocellular carcinoma (HCC) and metastatic carcinoma of the liver. Twelve patients in this group have been performed ultrasonically guided superantigen injections with radiopharmaceutical Yttrium-90 therapy at day 1, day 3, day 7, day 30. Ultrasonically guided fine needle biopsy has also been made at the same time. In the study, Immunohistochemical staining was used to measure the immune state of 12 patients with 28 tumors before and after real-time ultrasonographic guided intratumor injections of 90Y and superantigen for treatment of liver carcinoma with the doses of 1.0 mci/cm3 for 90Y and 2000U for superantigen each time. After injections in patients with liver carcinoma, the number of Th cells elevated significantly while that of Ts cells declined significantly than those before injections (p<0.01). Measuring T lymphocytes subsets in tumor site is helpful to know the immune state and has significance in directing therapy and judging prognosis. 90Y has been used for successful preclinical studies in liver cancers and has a half-life of 64 h and emits β-electrons with a maximum energy Emax of 2.27 Mev, giving it a maximum range in tissue of 12 mm.. For patients with liver carcinoma, the method of real-time ultrasonographic guided intratumor injections of 90Y and superantigen is an effective way to treat hepatocellular carcinoma, to improve local antitumor immune response.