CardioVascular and Interventional Radiology

, Volume 41, Issue 11, pp 1708–1715 | Cite as

Transarterial Embolization with Small-Size Particles Loaded with Irinotecan for the Treatment of Colorectal Liver Metastases: Results of the MIRACLE III Study

  • Giovanni MauriEmail author
  • Gianluca Maria Varano
  • Paolo Della Vigna
  • Guido Bonomo
  • Lorenzo Monfardini
  • Maria Giulia Zampino
  • Paola Simona Ravenda
  • Franco Orsi
Clinical Investigation
Part of the following topical collections:
  1. Interventional Oncology



This pilot study was performed to investigate safety and local tumor control following transarterial embolization with small-size particles loaded with irinotecan (DEB-IRI) in patients with colorectal liver metastases (CRLM).

Materials and Methods

Patients with pretreated CRLM with mono- or bilobar lesions involving less than 60% of the liver parenchyma and Eastern Cooperative Oncology Group performance status 0 or 1 underwent superselective DEB-IRI embolization with 40 µm diameter embolic microspheres.


Eighteen patients (11 males, 7 females, median age 61 years) underwent 80 embolization procedures (mean 4.4, range 2–12 per patient). No serious adverse events were reported within 30 days. A total of 39 treatment-related AEs occurred across all embolization procedures. No G4 or G5 treatment-related AEs occurred. Local tumor control, defined as complete response, partial response, or stable disease, was achieved in 16/18 (88.9%), 7/17 (41.2%), and 3/17 (17.6%) patients at 3, 6, and 12 months, respectively. Median liver progression-free survival was 5.9 months (range 27–409 days), and median overall survival was 13.5 months.


In this small series, DEB-IRI embolization with small beads was demonstrated a safe procedure in the treatment of patients with CRLM. The promising results in terms of liver-specific progression-free survival and overall survival reported deserve further confirmation in larger prospective trials.

Level of Evidence

Level 4, case series.


Colorectal liver metastases Transarterial chemoembolization Particles Survival Irinotecan 



Elizabeth J. Davis, Ph.D., (Boston Scientific, Maple Grove, MN) provided medical writing assistance.


The study was funded by CeloNova BioSciences (San Antonio, TX) and Boston Scientific (Marlborough, MA).

Compliance with Ethical Standards

Conflict of interest

GM received consultancy fee from Elesta SrL, speaker honorarium from Guerbet, and travel support by RGG; FO received travel support by RGG, CeloNova and Boston Scientific; all other authors declare they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

It was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  1. 1.Department of Interventional RadiologyEuropean Institute of OncologyMilanItaly
  2. 2.Unit of Interventional RadiologyBresciaItaly
  3. 3.Unit of Gastrointestinal Medical Oncology and Neuroendocrine TumorsEuropean Institute of OncologyMilanItaly

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