The Society of Interventional Radiology (SIR) is urging UnitedHealthcare (UHC) to update an important coverage policy that impacts patients with liver metastases—including those in the ocular melanoma community. On November 5, SIR submitted formal comments asking the insurer to expand access to transarterial radioembolization (TARE), also known as selective internal radiation therapy (SIRT)—a minimally invasive, targeted treatment that delivers Y-90 radioactive microspheres directly to tumor-feeding blood vessels. This technique destroys cancer cells while preserving healthy liver tissue, offering hope to patients who have few remaining treatment options.
Currently, UHC covers TARE for only a limited list of cancers that have spread to the liver, including colorectal cancer, neuroendocrine tumors, and importantly, ocular melanoma. While this coverage benefits many in our community, it still excludes a significant group of patients facing advanced, liver-dominant metastatic disease.
SIR is now advocating for broader coverage to include select patients with chemorefractory, unresectable liver metastases stemming from breast, pancreatic, prostate, and lung cancers. These cancers often present aggressive liver involvement, and many patients exhaust standard therapies before being considered for alternate options like Y-90 radioembolization.
Although the data for these additional cancers primarily come from non-randomized studies, SIR emphasizes the strength of cumulative clinical evidence: published meta-analyses, systematic reviews, prospective studies, and large multicenter evaluations consistently show that TARE can achieve meaningful tumor control, extend survival, and improve quality of life. For patients whose disease has progressed beyond conventional treatments, this approach can provide a crucial palliative option with real clinical impact.
In their letter to UHC leadership, SIR stressed that updating this policy would help “ensure equitable patient access to care regardless of plan type,” urging UnitedHealthcare to recognize the value, safety, and real-world effectiveness of Y-90 radioembolization.
For the ocular melanoma community—and for all patients living with rare or aggressive metastatic cancers—expanded access to innovative therapies like TARE is not just a policy question. It’s a matter of survival, fairness, and hope.
A Cure In Sight will continue monitoring these developments and advocating for equitable access to life-extending treatment options for all patients facing metastatic disease.