DEBIRI in Hepatic Malignancy: A Six-Patient Case Series in Indonesia

Irinotecan-loaded drug-eluting bead transarterial chemoembolization (DEBIRI) has an established but evolving evidence base for colorectal liver metastases, while its use in small-cell lung cancer (SCLC) liver metastases remains poorly characterized. To the best of our knowledge, this is the first published report of DEBIRI use from Indonesia. We describe a single-center case series of patients treated for colorectal liver metastases and small-cell lung cancer liver metastases. Six patients underwent DEBIRI at a tertiary oncology center: five with colorectal liver metastases and one with SCLC liver metastases. Clinical characteristics, procedural details, imaging response, toxicity, and outcomes were retrospectively reviewed. ECOG performance status ranged from 0 to 2. Cumulative irinotecan doses ranged from 40 to 360 mg across one to three sessions. Technical success was achieved in all procedures. Among five patients with evaluable follow-up, four had documented progression between 2.6 and 7.8 months, while one remained progression-free at last follow-up at 3.7 months. Three patients with CRLM demonstrated stable disease followed by documented progression at 3.7, 5.1, and 7.8 months. The SCLC case demonstrated progressive disease approximately 3 months after DEBIRI and subsequently showed a marked metabolic response following systemic chemotherapy. DEBIRI was technically feasible across colorectal liver metastases and SCLC with liver metastases. The colorectal cases were broadly consistent with published evidence, while the SCLC case is hypothesis-generating.