Yttrium-90 resin microspheres
Tiny radioactive beads are injected through a small tube into the artery that feeds the liver. They lodge in the tumour and give it radiation from the inside, mostly sparing the rest of the liver.
Overview
SIR-Spheres are yttrium-90-loaded resin microspheres delivered by transarterial radioembolisation (TARE/SIRT). Yttrium-90 is a pure beta emitter with a physical half-life of about 64 hours; delivery via the hepatic artery exploits the fact that liver tumours draw most of their blood supply from that vessel while normal liver parenchyma relies more on the portal vein.
The device holds the original 2002 FDA premarket approval (PMA P990065) for unresectable metastatic liver tumours from primary colorectal cancer, given together with adjuvant intrahepatic artery chemotherapy (floxuridine, FUDR). In July 2025 the FDA approved a labelling supplement extending the indication to local tumour control of unresectable hepatocellular carcinoma (HCC) in patients with no macrovascular invasion, Child-Pugh A cirrhosis, well-compensated liver function and good performance status, making SIR-Spheres the only US radioembolisation product approved for both indications.
Dosing is individualised: activity is planned using body-surface-area or partition (MIRD) dosimetry models with pre-treatment angiography and a technetium-99m macroaggregated albumin scan to check lung shunting before the therapeutic infusion. SIR-Spheres also carry regulatory approval in the EU (2002), Canada (2016), Australia (1998) and other markets.
1.Yttrium-90 resin microspheres slips into a pocket on its target.
- Route
- Intra-arterial infusion into the hepatic artery via catheter
- Schedule
- Single administration per treated liver territory; activity individualised by body-surface-area or partition-model dosimetry
- Monitoring
- Pre-treatment angiography and 99mTc-MAA lung-shunt scan; post-treatment imaging for dosimetry
Source: www.accessdata.fda.gov/cdrh_docs/pdf/P990065S014B.pdf. Doses are for orientation; the current label governs.
- Appraised for
- Unresectable advanced hepatocellular carcinoma, Child-Pugh grade A, where conventional transarterial therapies are inappropriate
- Notes
- TA688 appraised the selective internal radiation therapies together and recommends SIR-Spheres as an option under a commercial arrangement; last updated 3 July 2024.
- NHS England
- Routinely funded for the appraised indication (or via managed access)
Sources: NICE TA688. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 2002 | Unresectable metastatic liver tumours from primary colorectal cancer, with adjuvant intrahepatic artery chemotherapy (FUDR) |
| US | 2025 | Local tumour control of unresectable hepatocellular carcinoma (no macrovascular invasion, Child-Pugh A, well-compensated liver function, good performance status) |
Trials
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Latest papers
topQuery for this drug: (TITLE:"Yttrium-90 resin microspheres" OR ABSTRACT:"Yttrium-90 resin microspheres" OR TITLE:"SIR-Spheres" OR ABSTRACT:"SIR-Spheres" OR TITLE:"Y-90 resin microspheres" OR ABSTRACT:"Y-90 resin 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 Yttrium-90 resin microspheres, not a curated reading list.
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