Ep. 265 The TheraSphere Story with Dr. Riad Salem and Peter Pattison

Ep. 265 The TheraSphere Story with Dr. Riad Salem and Peter Pattison

In this crossover episode between BackTable VI and BackTable Innovation, Dr. Chris Beck interviews Dr. Riad Salem (Chief of Interventional Radiology at Northwestern University) and Peter Pattison (President of Interventional Oncology at Boston Scientific) about how TheraSpheres for Y90 radioembolization became a mainstay in the IR toolkit for HCC and where the technology is heading next. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/PvWJlD --- SHOW NOTES To begin, Peter outlines how the original concept of TheraSpheres began at the University of Missouri, as a collaboration between Drs. Delbert Day and Gary Ehrhardt, who combined their ceramic and nuclear chemistry expertises to create radioactive glass beads and published a paper in 1987. After animal and human testing, the product was licensed to the company Nordion, where Peter worked. The product was given a humanitarian device exemption (HDE) from the FDA, which allowed TheraSpheres to be used for investigational purposes. In the late 1990s, Dr. Salem was in his early interventional oncology career and heard about TheraSpheres. He recognized the enormous potential that this technology had to ensure known amounts of radioactive doses were delivered to the tumor and minimize adverse effects. In fact, he noticed that his Y90 patients had less pain, post-embolization syndrome, and hospitalization than his transarterial chemoembolization (TACE) patients. In the mid 2000s, he collected and submitted data to various conferences and journals, but he was met with criticism from the IR world, which was more comfortable with TACE, since it was the current standard of care. In 2011, Nordion decided to run a clinical trial, EPOCH, which eventually showed that the addition of TARE to systemic therapy for colorectal metastases to the liver led to longer progression free survival. Dr. Riad has focused his efforts on training more IRs on the methodology of Y90, since this was an important step to increasing adoption and minimizing missteps with the new technology. He believes that the advent of Y90 has resulted in better angiography, since IRs are more cognizant of off-target embolization. Dr. Salem also petitioned at the US Nuclear Regulatory Committee to allow IRs to become the authorized users for Y90 injection and advocated to add TARE to the National Comprehensive Cancer Network guidelines for liver cancer. Both of these developments allowed TARE to become more widely adopted. Finally, Peter discusses the competition that TheraSpheres has faced from TACE and SIRSpheres (resin-based radioembolization). He shares exciting new developments that have occurred since acquisition by Boston Scientific. These include exploration for the extra-hepatic use of TheraSpheres in glioblastoma and prostate cancer. --- RESOURCES BackTable Ep. 223- Portal Vein Recan #ReCanDoIt with Dr. Riad Salem: https://www.backtable.com/shows/vi/podcasts/223/portal-vein-recan-recandoit Therapeutic Use of 90Y Microspheres: https://pubmed.ncbi.nlm.nih.gov/3667306/ A phase I dose escalation trial of yttrium-90 microspheres in the treatment of primary hepatocellular carcinoma: https://pubmed.ncbi.nlm.nih.gov/1327493/ Hepatic radioembolization with yttrium-90 containing glass microspheres: preliminary results and clinical follow-up: https://pubmed.ncbi.nlm.nih.gov/7931662/ Humanitarian Device Exemption: https://www.fda.gov/medical-devices/premarket-submissions-selecting-and-preparing-correct-submission/humanitarian-device-exemption EPOCH Trial: https://ascopubs.org/doi/full/10.1200/JCO.21.01839 Radioembolization with 90Yttrium Microspheres: A State-of-the-Art Brachytherapy Treatment for Primary and Secondary Liver Malignancies: https://www.jvir.org/article/S1051-0443(07)60901-4/fulltext

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Ep. 463 Stone Retrieval and Other Advanced Biliary Interventions with Dr. Alexander Vezeridis

Ep. 463 Stone Retrieval and Other Advanced Biliary Interventions with Dr. Alexander Vezeridis

In this episode, Dr. Alexander Vezeridis discusses advanced biliary interventions; covering stone removal procedures, technical success rates, and practical tips for using Spyglass cholangioscopy, las...

12 Heinä 202453min

Ep. 462 IVC Filter Retrieval: Tips and Technique with Dr. Noor Ahmad

Ep. 462 IVC Filter Retrieval: Tips and Technique with Dr. Noor Ahmad

In this episode of the Back Table Podcast, interventional radiologist Dr. Noor Ahmad discusses his algorithm for complex inferior vena cava (IVC) filter retrievals and reviews several cases that utili...

9 Heinä 202445min

Ep. 461 Advanced Radial to Peripheral Interventions with Dr. Sameh Sayfo

Ep. 461 Advanced Radial to Peripheral Interventions with Dr. Sameh Sayfo

Dr. Sameh Sayfo discusses advanced techniques in radial to peripheral (R2P) interventions, the importance of having multiple techniques, the role of different devices, troubleshooting tips, and the ev...

2 Heinä 202458min

Ep. 460 What is POTS and Orthostatic Flow Syndrome? with Dr. Steven Smith

Ep. 460 What is POTS and Orthostatic Flow Syndrome? with Dr. Steven Smith

Dr. Ally Baheti interviews interventional radiologist Dr. Steven Smith about his insights into venous orthostatic flow dysfunction and its association with multisystem disorders. --- CHECK OUT OUR S...

28 Kesä 202445min

Ep. 459 Transitioning from Academia to Private OBL Practice with Dr. Jafar Golzarian

Ep. 459 Transitioning from Academia to Private OBL Practice with Dr. Jafar Golzarian

Dr. Jafar Golzarian shares his experiences with co-founding an outpatient-based lab (OBL), obtaining the right equipment, handling staffing, negotiating with insurance companies, and marketing his new...

25 Kesä 202448min

Ep. 458 AI Scribes: Enhancing Patient and Physician Interaction with Elie Toubiana

Ep. 458 AI Scribes: Enhancing Patient and Physician Interaction with Elie Toubiana

Dr. Aditya Bagrodia sits down with Elie Toubiana, founder and CEO of ScribeMD.ai, to discuss the transformative potential of artificial intelligence (AI) in medical documentation. --- SYNPOSIS Thei...

21 Kesä 202443min

Ep. 457 Sacroplasty II: Technique, Pearls, and Training Opportunities with Dr. Doug Beall

Ep. 457 Sacroplasty II: Technique, Pearls, and Training Opportunities with Dr. Doug Beall

In this episode of the Back Table MSK podcast, Dr. Jacob Fleming and Dr. Douglas Beall dive into the intricacies of sacroplasty, including considerations for selecting cement volume, efficacy of small...

20 Kesä 202440min

Ep. 456 Sacroplasty I: Principles and New Data in the Treatment of Sacral Insufficiency Fractures with Dr. Doug Beall

Ep. 456 Sacroplasty I: Principles and New Data in the Treatment of Sacral Insufficiency Fractures with Dr. Doug Beall

Dr. Jacob Fleming and Dr. Douglas Beall discuss the challenges and advancements in treating sacral insufficiency fractures (SIF), the importance of real-world data in evaluating treatment efficacy, an...

19 Kesä 202451min

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