Liver cancer is one of the fastest-growing and most difficult cancers to treat, now ranking as the third leading cause of cancer death worldwide. At the MCW Cancer Center, where liver cancer is a top research priority, scientists and clinicians are leading clinical studies to change its trajectory. One of the most promising is the ROUTE 90 trial, a prospective, multi-center study evaluating Eye90 microspheres®, a cutting-edge therapy that uses radioembolization to deliver radiation directly to liver tumors.
“This is the first new radioembolization platform to be developed in the last 20 years. The goal of ROUTE 90 is to evaluate the safety and effectiveness of this technology in improving tumor control and outcomes for patients with hepatocellular carcinoma, the most common type of liver cancer,” said William Rilling, MD, FSIR, Vice Chair and Professor of Radiology; local principal investigator of the trial
Radioembolization is a minimally invasive procedure that delivers millions of microscopic glass beads, called microspheres, through the hepatic artery, the main blood vessel that supplies the liver. Each sphere contains yttrium-90 (Y-90), a radioactive isotope that emits beta radiation to destroy cancer cells from within while sparing most of the surrounding healthy tissue.
“We did our first Y-90 treatment here at MCW in 2003,” said Dr. Rilling. “Since then, radioembolization has been used to treat both primary and metastatic liver tumors by delivering millions of 20–30 micron glass microspheres through the hepatic artery. These microspheres carry a radiation payload with the isotope yttrium-90, which has a radioactive half-life of about 64 hours.”
The Eye90 microsphere platform, developed by ABK Biomedical, builds on this proven method with new features that improve precision and visibility. Traditionally, Y-90 microspheres could not be seen once delivered, which limited physicians’ ability to confirm how evenly the treatment reached the tumor. Eye90 microspheres solve that problem. They can be visualized during the procedure using cone beam computed tomography (CT) scans and again afterward on post-treatment CT imaging.
“This may allow us to identify areas of suboptimal treatment more quickly. There are also some potential advantages with dosimetry flexibility and the novel delivery system,” added Dr. Rilling.
Behind every successful clinical trial is a team coordinating the complex logistics that make participation possible for patients. Lauren Schmitz, Clinical Research Coordinator for the Gastrointestinal Disease-Oriented Team, plays a key role in ROUTE 90 by scheduling study visits, ensuring data accuracy, and maintaining regular communication with patients and the Interventional Radiology team. However, the most meaningful part of her work is the patient connection.
“Out of all the trials I’ve worked on, this one requires the most patient support. You really get to know the patients on a personal level. They’re so appreciative of the communication and care they receive, and that relationship makes the work very meaningful,” said Schmitz.
So far, four patients have been enrolled in the ROUTE 90 trial at MCW. “The treatments have been well tolerated and patients are showing excellent early imaging response,” said Dr. Rilling. “We will need longer follow-up to determine efficacy.”
As Liver Cancer Awareness Month shines a spotlight on the urgent need for better prevention and treatment options, the ROUTE 90 trial demonstrates the MCW Cancer Center’s commitment to advancing care and improving outcomes. By combining innovation, teamwork, and patient-centered research, the Center continues to push the boundaries of liver cancer care and bring new options to patients close to home.
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