Selective internal radiation therapy with QuiremSpheres for treating unresectable advanced hepatocellular carcinoma

QuiremSpheres (Terumo) received its CE mark in April 2015. It is classified as an Active Implantable Medical Device by Council Regulation (EU2017/745). It is indicated for treating unresectable liver tumours.

QuiremSpheres is given through a catheter to the hepatic artery. The product is supplied as a customised, patient-specific dose. The maximum range of the emitted beta particles in tissue is 8.7 mm with a mean of 2.5 mm. Also, holmium‑166 emits primary gamma photons (81 kilo electronvolt). The half-life is 26.8 hours, which means more than 90% of the radiation is given in the first 4 days after the procedure. At the moment of treatment, the activity per microsphere is 200 to 400 Becquerel. The number of particles implanted depends on the targeted liver volume and ranges, on average, from 10 to 30 million.

The company has stated that the acquisition cost of QuiremSpheres is £12,000 for a single treatment. The company has a commercial arrangement. This makes QuiremSpheres available to the NHS with a discount. The size of the discount is commercial in confidence.