{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T04:27:25Z","timestamp":1787632045817,"version":"build-2736575974"},"reference-count":29,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIH","award":["U01 CA278470"],"award-info":[{"award-number":["U01 CA278470"]}]},{"name":"NIH","award":["R01 CA226803"],"award-info":[{"award-number":["R01 CA226803"]}]},{"name":"NIH","award":["P30 CA023100"],"award-info":[{"award-number":["P30 CA023100"]}]},{"name":"FDA","award":["R01 FD006334"],"award-info":[{"award-number":["R01 FD006334"]}]},{"name":"GIST Research Fund","award":["3661"],"award-info":[{"award-number":["3661"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Succinate dehydrogenase (SDH)-deficient gastrointestinal stromal tumors (GISTs) are a rare subgroup of GISTs and respond poorly to conventional systemic therapies. This study describes long-term outcomes after yttrium-90 (Y-90) selective internal radiation therapy (SIRT) for progression of unresectable SDH-deficient GIST hepatic metastases. Methods: We performed a retrospective review of consecutive patients treated with SIRT at three tertiary referral centers in Europe and the United States. Data collection included demographics, tumor profiling, prior therapies, Y-90 dosimetry approach, imaging response, adverse events, and long-term outcomes. Results: Twelve patients (66.7% female) with a median age of 27 years (range, 17\u201357 years) were included. One patient had a complete response (8.3%) and seven had partial responses (58.3%) by modified Response Evaluation Criteria in Solid Tumors. Four patients (33.3%) had tumor shrinkage that did not meet partial response criteria. The objective response rate was 66.7%, with a disease control rate of 100%. One grade 3 or higher adverse event was observed (cholecystitis requiring cholecystectomy). At a median follow-up of 32 months (range, 3\u201377 months), two patients experienced disease progression. Median overall survival was not reached, with one death during follow-up. Conclusions: SIRT appears safe and effective for patients with progressive, unresectable SDH-deficient GIST hepatic metastases, with durable responses and limited serious toxicity. These findings suggest that SDH-deficient GIST may be more sensitive to radiation than previously appreciated and that SIRT may be a useful liver-directed approach for patients with limited systemic options.<\/jats:p>","DOI":"10.3390\/cancers18162704","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:05:19Z","timestamp":1787241919000},"page":"2704","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Selective Internal Radiation Therapy (SIRT) for SDH-Deficient GIST Demonstrates Encouraging Durable Response Rates: An International Multicenter Case Series"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8651-9772","authenticated-orcid":false,"given":"Zachary T.","family":"Berman","sequence":"first","affiliation":[{"name":"Department of Radiology, Division of Interventional Radiology, University of California San Diego, San Diego, CA 92103, USA"},{"name":"Moores Cancer Center, University of California San Diego, La Jolla, CA 92037, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5359-5923","authenticated-orcid":false,"given":"Peter","family":"Hohenberger","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, 68135 Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramesh","family":"Bulusu","sequence":"additional","affiliation":[{"name":"Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven C.","family":"Rose","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Interventional Radiology, University of California San Diego, San Diego, CA 92103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul T.","family":"Fanta","sequence":"additional","affiliation":[{"name":"Moores Cancer Center, University of California San Diego, La Jolla, CA 92037, USA"},{"name":"Department of Medicine, Division of Medical Oncology, University of California San Diego, San Diego, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Radiology, Royal Liverpool University Hospital, Prescot St., Liverpool L7 8XP, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Diehl","sequence":"additional","affiliation":[{"name":"Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, 68167 Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franka","family":"Menge","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, 68135 Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasim","family":"Ali","sequence":"additional","affiliation":[{"name":"The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral CH63 4JY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4403-0271","authenticated-orcid":false,"given":"Jason K.","family":"Sicklick","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Interventional Radiology, University of California San Diego, San Diego, CA 92103, USA"},{"name":"Moores Cancer Center, University of California San Diego, La Jolla, CA 92037, USA"},{"name":"Department of Surgery, Division of Surgical Oncology, University of California San Diego, San Diego, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1001\/jamaoncol.2016.0256","article-title":"Molecular subtypes of KIT\/PDGFRA wild-type gastrointestinal stromal tumors: A report from the National Institutes of Health Gastrointestinal Stromal Tumor Clinic","volume":"2","author":"Boikos","year":"2016","journal-title":"JAMA Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1007\/s10555-019-09818-0","article-title":"Current management of succinate dehydrogenase-deficient gastrointestinal stromal tumors","volume":"38","author":"Neppala","year":"2019","journal-title":"Cancer Metastasis Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2833","DOI":"10.1002\/cncr.22336","article-title":"Hepatic artery chemoembolization for 110 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