1468 – SIR-Spheres for the treatment of hepatic metastases, and other indications not listed on the MBS

Amendment to existing MBS items/New MBS items.

SIR-Spheres (Selective Internal Radiation Spheres) are yttrium-90 resin microspheres that are implanted into malignant liver tumours for the purpose of selectively delivering high doses of ionising radiation to the tumour. They are injected into the hepatic artery by means of a trans-femoral catheter or a permanently implanted hepatic artery port with a catheter. Following injection, the SIR-Spheres Y-90 resin microspheres become concentrated in the microvasculature of the liver tumours, where they have a local radiotherapeutic effect. As tumours within the liver derive their blood supply almost exclusively from the hepatic artery, the SIR-Spheres Y-90 resin microspheres are preferentially delivered in greater amounts to the tumour rather than to the normal liver parenchyma, which is supplied by both the hepatic artery and the portal vein. Following decay of the yttrium-90, the inert resin microspheres remain implanted in the tissue.

Type: Therapeutic

Part 1

This application is requesting full listing for interim-listed MBS items 35404, 35406 and 35408. These items cover selective internal radiation therapy (SIRT) using SIR-Spheres for the treatment of hepatic metastases which are secondary to colorectal cancer and are not suitable for resection or ablation, used in combination with systemic chemotherapy using 5-fluorouracil (5FU) and leucovorin.

Part 2

This application is also requesting new MBS listings for SIRT for the treatment of the following indications:

• non-resectable, non-ablatable hepatocellular carcinoma (advanced HCC)
• unresectable intrahepatic cholangiocarcinoma (ICC)
• liver dominant tumours (incl. breast cancer)
• neuroendocrine tumours (NETs)

• PASC meeting: 12 April 2017
• ESC meeting: -
• MSAC meeting: -