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ESMO 2026 | PALEM: palliative arterial embolization for painful bone metastases

Yasunori Arai, MD, National Cancer Center, Kashiwa, Japan, discusses results from the PALEM (UMIN000040794) trial evaluating palliative arterial embolization of tumor-feeding vessels for painful bone metastases in patients ineligible for, or previously treated with, radiotherapy. Embolization with microspheres provided immediate pain relief within days in over half of patients, based on pain scores and opioid use, with no predefined serious embolization-related adverse events. This interview took place at the European Society for Medical Oncology (ESMO) 2026 Congress in Madrid, Spain.

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Transcript

Yes, PALEM trial is a confirmatory trial, a confirmatory, a multicenter single-arm confirmatory trial for painful bone metastasis using arterial embolization. This trial has two co-primary endpoints, safety and immediate efficacy. And immediate efficacy is defined as pain relief response at 72 hours. And the second was safety, and the safety was an embolization-related protocol to find severe adverse events...

Yes, PALEM trial is a confirmatory trial, a confirmatory, a multicenter single-arm confirmatory trial for painful bone metastasis using arterial embolization. This trial has two co-primary endpoints, safety and immediate efficacy. And immediate efficacy is defined as pain relief response at 72 hours. And the second was safety, and the safety was an embolization-related protocol to find severe adverse events. And the result, pain relief response at 72 hours was 50.5%. And for the second endpoint, safety, there were no severe adverse events among 190 patients.

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