Holmium-166 microspheres
Tiny plastic beads carrying a radioactive, slightly magnetic metal are injected into the artery feeding a liver tumour. Because the metal shows up on both nuclear scans and MRI, doctors can check exactly where the beads went.
Overview
QuiremSpheres are holmium-166-labelled poly-L-lactic acid microspheres for radioembolisation (SIRT) of unresectable liver tumours, developed at University Medical Center Utrecht and commercialised by Quirem Medical (later acquired by Terumo). Holmium-166 has a physical half-life of 26.8 hours, so more than 90% of the radiation dose is delivered within the first four days after administration.
The product received CE marking as an active implantable medical device in April 2015, and a matching low-activity test dose (QuiremScout, identical size and shape) was CE-marked in 2018-2019 to predict lung shunting and biodistribution before therapy. Holmium-166 emits both beta particles (for therapy) and a gamma photon, and is paramagnetic, which allows quantitative SPECT and MRI-based dosimetry after treatment, alongside the more usual post-treatment imaging used for yttrium-90 products.
QuiremSpheres has not obtained FDA approval and is used in Europe and other CE-mark-recognising markets; NICE (UK) technology appraisal TA985 reviewed its use in advanced HCC. It is one of three commercially available liver radioembolisation microsphere products, alongside the yttrium-90 resin (SIR-Spheres) and glass (TheraSphere) microspheres.
1.Holmium-166 microspheres slips into a pocket on its target.
- Route
- Intra-arterial infusion into the hepatic artery via catheter
- Schedule
- Single administration, typically with a QuiremScout test dose beforehand for dosimetry
Source: www.nice.org.uk/guidance/ta985/chapter/2-Information-about-QuiremSpheres. Doses are for orientation; the current label governs.
Approvals
| Region | Year | Indication |
|---|---|---|
| EU | 2015 | Treatment of unresectable liver tumours (radioembolisation) |
Trials
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Latest papers
topQuery for this drug: (TITLE:"Holmium-166 microspheres" OR ABSTRACT:"Holmium-166 microspheres" OR TITLE:"QuiremSpheres" OR ABSTRACT:"QuiremSpheres" OR TITLE:"166Ho-PLLA microspheres" OR ABSTRACT:"166Ho-PLLA microspheres") AND (radiopharmaceutical OR radioligand OR radionuclide OR theranostic OR "nuclear medicine" OR "molecular imaging" OR radiotracer OR scintigraphy OR cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Holmium-166 microspheres, not a curated reading list.
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