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Srinivasan ES, Liu Y, Odion RA, Chongsathidkiet P, Wachsmuth LP, Haskell-Mendoza AP, Edwards RM, Canning AJ, Willoughby G, Hinton J, Norton SJ, Lascola CD, Maccarini PF, Mariani CL, Vo-Dinh T, Fecci PE. Gold Nanostars Obviate Limitations to Laser Interstitial Thermal Therapy (LITT) for the Treatment of Intracranial Tumors. Clin Cancer Res 2023; 29:3214-3224. [PMID: 37327318 PMCID: PMC10425731 DOI: 10.1158/1078-0432.ccr-22-1871] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 03/27/2023] [Accepted: 06/14/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE Laser interstitial thermal therapy (LITT) is an effective minimally invasive treatment option for intracranial tumors. Our group produced plasmonics-active gold nanostars (GNS) designed to preferentially accumulate within intracranial tumors and amplify the ablative capacity of LITT. EXPERIMENTAL DESIGN The impact of GNS on LITT coverage capacity was tested in ex vivo models using clinical LITT equipment and agarose gel-based phantoms of control and GNS-infused central "tumors." In vivo accumulation of GNS and amplification of ablation were tested in murine intracranial and extracranial tumor models followed by intravenous GNS injection, PET/CT, two-photon photoluminescence, inductively coupled plasma mass spectrometry (ICP-MS), histopathology, and laser ablation. RESULTS Monte Carlo simulations demonstrated the potential of GNS to accelerate and specify thermal distributions. In ex vivo cuboid tumor phantoms, the GNS-infused phantom heated 5.5× faster than the control. In a split-cylinder tumor phantom, the GNS-infused border heated 2× faster and the surrounding area was exposed to 30% lower temperatures, with margin conformation observed in a model of irregular GNS distribution. In vivo, GNS preferentially accumulated within intracranial tumors on PET/CT, two-photon photoluminescence, and ICP-MS at 24 and 72 hours and significantly expedited and increased the maximal temperature achieved in laser ablation compared with control. CONCLUSIONS Our results provide evidence for use of GNS to improve the efficiency and potentially safety of LITT. The in vivo data support selective accumulation within intracranial tumors and amplification of laser ablation, and the GNS-infused phantom experiments demonstrate increased rates of heating, heat contouring to tumor borders, and decreased heating of surrounding regions representing normal structures.
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Affiliation(s)
- Ethan S. Srinivasan
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
| | - Yang Liu
- Department of Biomedical Engineering, Duke University, Durham, North Carolina
- Department of Chemistry, Duke University, Durham, North Carolina
- Fitzpatrick Institute of Photonics, Duke University, Durham, North Carolina
| | - Ren A. Odion
- Department of Biomedical Engineering, Duke University, Durham, North Carolina
- Fitzpatrick Institute of Photonics, Duke University, Durham, North Carolina
| | - Pakawat Chongsathidkiet
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
- Department of Pathology, Duke University Medical Center, Durham, North Carolina
| | - Lucas P. Wachsmuth
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
| | | | - Ryan M. Edwards
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
| | - Aidan J. Canning
- Department of Biomedical Engineering, Duke University, Durham, North Carolina
- Fitzpatrick Institute of Photonics, Duke University, Durham, North Carolina
| | - Gavin Willoughby
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
- Department of Pathology, Duke University Medical Center, Durham, North Carolina
| | - Joseph Hinton
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
- Department of Pathology, Duke University Medical Center, Durham, North Carolina
| | - Stephen J. Norton
- Department of Biomedical Engineering, Duke University, Durham, North Carolina
- Fitzpatrick Institute of Photonics, Duke University, Durham, North Carolina
| | - Christopher D. Lascola
- Department of Radiology, Duke University Medical Center, Durham, North Carolina
- Department of Neurobiology, Duke University Medical Center, Durham, North Carolina
| | - Paolo F. Maccarini
- Department of Biomedical Engineering, Duke University, Durham, North Carolina
- Fitzpatrick Institute of Photonics, Duke University, Durham, North Carolina
| | - Christopher L. Mariani
- Department of Clinical Sciences, NC State College of Veterinary Medicine, Raleigh, North Carolina
| | - Tuan Vo-Dinh
- Department of Biomedical Engineering, Duke University, Durham, North Carolina
- Department of Chemistry, Duke University, Durham, North Carolina
- Fitzpatrick Institute of Photonics, Duke University, Durham, North Carolina
| | - Peter E. Fecci
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
- Department of Pathology, Duke University Medical Center, Durham, North Carolina
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Srinivasan ES, Sankey EW, Grabowski MM, Chongsathidkiet P, Fecci PE. The intersection between immunotherapy and laser interstitial thermal therapy: a multipronged future of neuro-oncology. Int J Hyperthermia 2020; 37:27-34. [PMID: 32672126 PMCID: PMC11229985 DOI: 10.1080/02656736.2020.1746413] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/04/2020] [Accepted: 03/15/2020] [Indexed: 10/23/2022] Open
Abstract
The rise of immunotherapy (IT) in oncological treatment has greatly improved outcomes in a number of disease states. However, its use in tumors of the central nervous system (CNS) remains limited for multiple reasons related to the unique immunologic tumor microenvironment. As such, it is valuable to consider the intersection of IT with additional treatment methods that may improve access to the CNS and effectiveness of existing IT modalities. One such combination is the pairing of IT with localized hyperthermia (HT) generated through technologies such as laser interstitial thermal therapy (LITT). The wide-ranging immunomodulatory effects of localized and whole-body HT have been investigated for some time. Hyperthermia has demonstrated immunostimulatory effects at the level of tumor cells, immune cells, and the broader environment governing potential immune surveillance. A thorough understanding of these effects as well as the current and upcoming investigations of such in combination with IT is important in considering the future directions of neuro-oncology.
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Affiliation(s)
- Ethan S Srinivasan
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
| | - Eric W Sankey
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | | | | | - Peter E Fecci
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
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