Imageable holmium-166 microspheres for SIRT

see what you treat, treat what you see

Next-generation microspheres for SIRT

QuiremSpheres® consists of Holmium-166 microspheres that have the same mode of action as existing Yttrium-90 based SIRT products: the microspheres emit beta radiation that kills tumor cells from close range. However, QuiremSpheres® can be visualized with SPECT and MR imaging, even in low concentrations. This is unique and cannot be done with currently available Yttrium-90 based microspheres and enables accurate verification of the delivered dose after the treatment. QuiremSpheres® comes with Q-suite, a proprietary software tool to calculate the absorbed dose based on the SPECT and MR images.

QuiremSpheres® consists of biocompatible poly-L-lactic acid (PLLA) microspheres containing Holmium-166. The microspheres have a mean diameter of 30 micrometer (97% between 15 to 60 micrometer). Holmium-166 is a high-energy beta emitting isotope for therapeutic use. The maximum energy of the beta particles is 1.85 MeV (50.0%) and 1.77 MeV (48.7%). The maximum range of the emitted beta particles in tissue is 8.7 mm with a mean of 2.5 mm. In addition, Holmium-166 emits primary gamma photons (81 KeV). The half-life is 26.8 hours, which means more than 90% of the radiation is delivered within the first 4 days following the implantation procedure. At planned moment of treatment, the activity per microsphere is approximately 240-375 Bq. QuiremSpheres® is a permanent implant.

QuiremSpheres® is indicated for the treatment of unresectable liver tumours.

QuiremSpheres® is intended for implantation into hepatic tumours by delivery via the hepatic artery.

As outpatient treatment, QuiremSpheres® are injected by a microcatheter in the hepatic artery and are transported by the blood flow to the tumor(s) in the liver. The tip of the microcatheter is put in the optimal position, as determined during the pre-treatment planning phase. The full procedure takes about 60 minutes.

It is strongly recommended to use the QuiremSpheres® administration system for performing the implantation of the QuiremSpheres® microspheres.

QuiremSpheres® microspheres are contraindicated in patients who have:

  • had previous external beam radiation therapy to the liver;
  • ascites or are in clinical liver failure;
  • inadequate liver function
  • significantly abnormal synthetic and excretory liver function tests (LFTs);
  • a lung dose exceeding 30 Gy in a single treatment.
  • a pre-assessment angiogram that demonstrates abnormal vascular anatomy that would result in significant reflux of hepatic arterial blood to the stomach, pancreas or bowel;
  • been treated with capecitabine within two months prior to treatment, or who will be treated with capecitabine at any time following treatment with QuiremSpheres®;
  • complete main portal vein thrombosis;
  • inadequate kidney function
  • uncorrectable extrahepatic deposition. Activity in the falciform ligament, portal lymph nodes and gallbladder is accepted.

You can download the Instructions for Use on the Product Documentation page.

next-generation microspheres for sirt

QuiremSpheres® is safe1 and effective2 for treating unresectable liver tumors

QuiremSpheres® offer an innovative way of treating unresectable cancers in the liver by means of Selective Internal Radiotherapy (SIRT). It is the only commercially available SIRT product based on holmium-166. Holmium has unique imaging properties, allowing the physician to treat what he sees and see what he treats.
“We performed our first QuiremSpheres® procedure on an mCRC patient. We were impressed with the tumor response we saw after 45 day follow-up on both anatomical imaging and FDG-PET." Click here to see the full case.
Dr. I. Bargellini
Interventional Radiologist, Ospedale Cisanello, Pisa

How to get started with QuiremSpheres®
in 6 simple steps

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