NHS England (NSHE) will commission selective internal radiation therapy (SIRT) for chemotherapy refractory / intolerant metastatic colorectal cancer in adults (see NHSE Commissioning Policy for more details).

Yttrium-90 radioactive isotopes

SIR-Spheres (Sirtex)

• Resin microspheres containing Yttrium-90 isotopes

Notes

1. NICE TA688: The selective internal radiation therapy (SIRT) SIR‑Spheres is recommended as an option for treating unresectable advanced hepatocellular carcinoma (HCC) in adults (March 2021), only if:
   1. used for people with Child–Pugh grade A liver impairment when conventional transarterial therapies are inappropriate, and
   2. the company provides SIR‑Spheres according to the commercial arrangement

TheraSphere (BTG)

• Glass microspheres containing Yttrium-90 isotopes

Notes

1. NICE TA688: The selective internal radiation therapy (SIRT) TheraSphere is recommended as an option for treating unresectable advanced hepatocellular carcinoma (HCC) in adults (March 2021), only if:
   1. used for people with Child–Pugh grade A liver impairment when conventional transarterial therapies are inappropriate, and
   2. the company provides TheraSphere according to the commercial arrangement

Holmium-166 radioactive isotopes

QuiremSpheres (Terumo)

• Poly (L-lactic acid) microspheres containing Holmium-166 isotopes

Notes

1. NICE TA985: The selective internal radiation therapy (SIRT) QuiremSpheres is recommended as an option for treating unresectable advanced hepatocellular carcinoma (HCC) in adults (July 2024), only if it is:
   1. used for people with Child-Pugh grade A liver impairment when conventional transarterial therapies are inappropriate, and
   2. the company provides it according to the commercial arrangement.