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Liu Q, Chen X, Qi M, Li Y, Chen W, Zhang C, Wang J, Han Z, Zhang C. Combined cryoablation and PD-1 inhibitor synergistically enhance antitumor immune responses in Lewis lung adenocarcinoma mice via the PI3K/AKT/mTOR pathway. Biochim Biophys Acta Mol Basis Dis 2024; 1870:167262. [PMID: 38815768 DOI: 10.1016/j.bbadis.2024.167262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 06/01/2024]
Abstract
Cryoablation is a therapeutic modality for lung adenocarcinoma that destroys target tumors using lethal levels of cold, resulting in the release of large amounts of specific antigens that activate immune responses. However, tumor immune checkpoint escape mechanisms prevent these released self-antigens from inducing effective anti-tumor immune responses. To overcome this challenge, we propose the use of immune checkpoint inhibitors to relieve T cell inhibition by immune checkpoints and enhance the anti-tumor immune response mediated by cryoablation. We used bilateral tumor-bearing mouse models and a specific cryoablation instrument to study the efficacy of cryoablation combined with PD-1 inhibitors in Lewis lung adenocarcinoma model mice. We found that cryoablation combined with PD-1 inhibitors significantly inhibited the growth of mouse lung adenocarcinoma, prolonged mouse survival, and enhanced the anti-tumor immune response. Moreover, this combined regimen could synergistically promote the activation and proliferation of T cells via the PI3K/AKT/mTOR pathway. The present study provides a strong theoretical basis for the clinical combination of cryoablation and PD-1 inhibitors.
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Affiliation(s)
- Qi Liu
- Department of Pulmonary and Critical Care Medicine, The Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China; Navy Clinical College, the Fifth School of Clinical Medicine, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Xuxin Chen
- Department of Pulmonary and Critical Care Medicine, The Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China; College of Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing 100091, China
| | - Man Qi
- Department of Pulmonary and Critical Care Medicine, The Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China; College of Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing 100091, China; Beijing Key Laboratory of OTIR, Beijing 100091, China
| | - Yongqun Li
- Department of Pulmonary and Critical Care Medicine, The Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China; College of Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing 100091, China
| | - Wei Chen
- Department of Pulmonary and Critical Care Medicine, The Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China; College of Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing 100091, China
| | - Caiyun Zhang
- Department of Pulmonary and Critical Care Medicine, The Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Jiaxin Wang
- Department of Pulmonary and Critical Care Medicine, The Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Zhihai Han
- Department of Pulmonary and Critical Care Medicine, The Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China; College of Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing 100091, China; Beijing Key Laboratory of OTIR, Beijing 100091, China; Navy Clinical College, the Fifth School of Clinical Medicine, Anhui Medical University, Hefei 230032, Anhui Province, China.
| | - Chunyang Zhang
- Department of Pulmonary and Critical Care Medicine, The Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China; College of Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing 100091, China.
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Santucci KL, Snyder KK, Van Buskirk RG, Baust JG, Baust JM. Investigation of Lung Cancer Cell Response to Cryoablation and Adjunctive Gemcitabine-Based Cryo-Chemotherapy Using the A549 Cell Line. Biomedicines 2024; 12:1239. [PMID: 38927445 PMCID: PMC11200978 DOI: 10.3390/biomedicines12061239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/17/2024] [Accepted: 05/25/2024] [Indexed: 06/28/2024] Open
Abstract
Due to the rising annual incidence of lung cancer (LC), new treatment strategies are needed. While various options exist, many, if not all, remain suboptimal. Several studies have shown cryoablation to be a promising approach. Yet, a lack of basic information pertaining to LC response to freezing and requirement for percutaneous access has limited clinical use. In this study, we investigated the A549 lung carcinoma cell line response to freezing. The data show that a single 5 min freeze to -15 °C did not affect cell viability, whereas -20 °C and -25 °C result in a significant reduction in viability 1 day post freeze to <10%. These populations, however, were able to recover in culture. Application of a repeat (double) freeze resulted in complete cell death at -25 °C. Studies investigating the impact of adjunctive gemcitabine (75 nM) pretreatment in combination with freezing were then conducted. Exposure to gemcitabine alone resulted in minimal cell death. The combination of gemcitabine pretreatment and a -20 °C single freeze as well as combination treatment with a -15 °C repeat freeze both resulted in complete cell death. This suggests that gemcitabine pretreatment may be synergistically effective when combined with freezing. Studies into the modes of cell death associated with the increased cell death revealed the increased involvement of necroptosis in combination treatment. In summary, these results suggest that repeat freezing to -20 °C to -25 °C results in a high degree of LC destruction. Further, the data suggest that the combination of gemcitabine pretreatment and freezing resulted in a shift of the minimum lethal temperature for LC from -25 °C to -15 °C. These findings, in combination with previous reports, suggest that cryoablation alone or in combination with chemotherapy may provide an improved path for the treatment of LC.
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Affiliation(s)
| | - Kristi K. Snyder
- CPSI Biotech, Owego, NY 13827, USA
- Phase Therapeutics, Inc., Owego, NY 13827, USA
| | - Robert G. Van Buskirk
- CPSI Biotech, Owego, NY 13827, USA
- Center for Translational Stem Cell and Tissue Engineering, Binghamton University, Binghamton, NY 13902, USA
- Department of Biological Sciences, Binghamton University, Binghamton, NY 13902, USA
| | - John G. Baust
- Center for Translational Stem Cell and Tissue Engineering, Binghamton University, Binghamton, NY 13902, USA
- Department of Biological Sciences, Binghamton University, Binghamton, NY 13902, USA
| | - John M. Baust
- CPSI Biotech, Owego, NY 13827, USA
- Phase Therapeutics, Inc., Owego, NY 13827, USA
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Chen Y, Fang X, Wang D, Li Q, Zhang K, Li Y, Li J, Pang H, Cheng Z, Zhang C, Zhang C, Yang W, Zhu B, Fan H, Han C, An Y, Zhang L, Luo B, Zhang S, Lu T, Meng Y, Jiao Q, Tang H, Zhou T, Hu K. Is cryoablation still suitable for advanced non-small cell lung cancer after failure of first-line chemotherapy? A multicenter, prospective, randomized-controlled trial of eighty-seven patients. Cryobiology 2024; 115:104864. [PMID: 38387752 DOI: 10.1016/j.cryobiol.2024.104864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/08/2024] [Accepted: 02/14/2024] [Indexed: 02/24/2024]
Abstract
The aim of this study was to investigate the therapeutic effect of cryoablation treatment in advanced NSCLC patients who had failed first-line chemotherapy. Eighty-seven patients from ten hospitals in China were enrolled into the study, forty-four patients received cryoablation treatment plus basic treatment (experimental group), and forty-three patients had basic treatment alone (control group). Follow-up was performed once every three months until the end of the study or the death of the patient. The primary endpoints were overall and post-intervention survival; secondary endpoints included tumor markers, solid tumor efficacy, and symptom changes before and after treatment. There was no significant difference in median OS between the two groups of patients (9.0 months vs 11.2 months, P = 0.583). The disease control rate (DCR) and living quality of the experimental group was higher than that of the control group. In terms of OS, indiscriminate use of cryoablation for such patients was not beneficial, though it could improve symptoms of patients. Cryoablation had a significant effect on selected advanced NSCLC patients after the failure of first-line chemotherapy.
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Affiliation(s)
- Yu Chen
- Department of Oncology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xueni Fang
- Department of Oncology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Dan Wang
- Department of Oncology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Quanwang Li
- Department of Oncology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Kerui Zhang
- Department of Oncology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yuan Li
- Department of Oncology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jinghua Li
- Department of Oncology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Haoyue Pang
- Department of Oncology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhiqiang Cheng
- Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, China
| | - Chunyang Zhang
- Department of Respiratory, The Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Caiyun Zhang
- Department of Respiratory, The Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Wuwei Yang
- Department of Tumor Minimally Invasive Treatment, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Baorang Zhu
- Department of Tumor Minimally Invasive Treatment, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Huanfang Fan
- Department of Oncology, Hebei Province Hospital of Traditional Chinese Medicine, Shijiazhuang, China
| | - Changhui Han
- Department of Oncology, Hebei Province Hospital of Traditional Chinese Medicine, Shijiazhuang, China
| | - Yonghui An
- Department of Oncology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lingling Zhang
- Department of Oncology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Baoping Luo
- Department of Oncology, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Siqi Zhang
- Department of Oncology, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Taiying Lu
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuanyuan Meng
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qinshu Jiao
- Department of Intervention, Zhengzhou Traditional Chinese Medicine Hospital, Zhengzhou, China
| | - Houlin Tang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tian Zhou
- Department of Oncology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.
| | - Kaiwen Hu
- Department of Oncology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.
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Bonnet B, Tournier L, Deschamps F, Yevich S, Marabelle A, Robert C, Albiges L, Besse B, Bonnet V, De Baère T, Tselikas L. Thermal Ablation Combined with Immune Checkpoint Blockers: A 10-Year Monocentric Experience. Cancers (Basel) 2024; 16:855. [PMID: 38473217 DOI: 10.3390/cancers16050855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 03/14/2024] Open
Abstract
PURPOSE We report a 10-year experience in cancer therapy with concomitant treatment of percutaneous thermal ablation (PTA) and immune checkpoint blockers (ICBs). MATERIAL AND METHODS This retrospective cohort study included all patients at a single tertiary cancer center who had received ICBs at most 90 days before, or 30 days after, PTA. Feasibility and safety were assessed as the primary outcomes. The procedure-related complications and immune-related adverse events (irAEs) were categorized according to the Common Terminology Criteria for Adverse Events v5.0 (CTCAE). Efficacy was evaluated based on overall survival (OS), progression-free survival (PFS), and local progression-free survival (LPFS) according to the indication, ablation modality, neoplasm histology, and ICB type. RESULTS Between 2010 and 2021, 78 patients (57% male; median age: 61 years) were included. The PTA modality was predominantly cryoablation (CA) (61%), followed by radiofrequency ablation (RFA) (31%). PTA indications were the treatment of oligo-persistence (29%), oligo-progression (14%), and palliation of symptomatic lesions or prevention of skeletal-related events (SREs) (56%). Most patients received anti-PD1 ICB monotherapy with pembrolizumab (n = 35) or nivolumab (n = 24). The feasibility was excellent, with all combined treatment performed and completed as planned. Ten patients (13%) experienced procedure-related complications (90% grade 1-2), and 34 patients (44%) experienced an irAE (86% grade 1-2). The only factor statistically associated with better OS and PFS was the ablation indication, favoring oligo-persistence (p = 0.02). Tumor response was suggestive of an abscopal effect in four patients (5%). CONCLUSIONS The concomitant treatment of PTA and ICBs within 2-4 weeks is feasible and safe for both palliative and local control indications. Overall, PTA outcomes were found to be similar to standards for patients not on ICB therapy. While a consistently reproducible abscopal effect remains elusive, the safety profile of concomitant therapy provides the framework for continued assessment as ICB therapies evolve.
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Affiliation(s)
- Baptiste Bonnet
- Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), F-94805 Villejuif, France
| | - Louis Tournier
- Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), F-94805 Villejuif, France
- Department of Radiology, Saint-Louis Hospital, Université de Paris, F-75010 Paris, France
| | - Frédéric Deschamps
- Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), F-94805 Villejuif, France
| | - Steven Yevich
- Department of Interventional Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Aurélien Marabelle
- Drug Development Department (DITEP), F-94805 Villejuif, France
- Laboratoire de Recherche Translationnelle en Immunothérapies (LRTI), Inserm U1015, F-94805 Villejuif, France
- Faculty of Medicine, Paris-Saclay University, F-94276 Le Kremlin Bicêtre, France
| | - Caroline Robert
- Faculty of Medicine, Paris-Saclay University, F-94276 Le Kremlin Bicêtre, France
- Gustave Roussy, Département de Médecine Oncologique, F-94805 Villejuif, France
| | - Laurence Albiges
- Faculty of Medicine, Paris-Saclay University, F-94276 Le Kremlin Bicêtre, France
- Gustave Roussy, Département de Médecine Oncologique, F-94805 Villejuif, France
| | - Benjamin Besse
- Faculty of Medicine, Paris-Saclay University, F-94276 Le Kremlin Bicêtre, France
- Gustave Roussy, Département de Médecine Oncologique, F-94805 Villejuif, France
| | - Victoire Bonnet
- Medicine Department, Campus Pierre et Marie Curie, Sorbonne University, 4 Place Jussieu, F-75005 Paris, France
| | - Thierry De Baère
- Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), F-94805 Villejuif, France
- Faculty of Medicine, Paris-Saclay University, F-94276 Le Kremlin Bicêtre, France
| | - Lambros Tselikas
- Gustave Roussy, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), F-94805 Villejuif, France
- Laboratoire de Recherche Translationnelle en Immunothérapies (LRTI), Inserm U1015, F-94805 Villejuif, France
- Faculty of Medicine, Paris-Saclay University, F-94276 Le Kremlin Bicêtre, France
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Liu Q, Zhang C, Chen X, Han Z. Modern cancer therapy: cryoablation meets immune checkpoint blockade. Front Oncol 2024; 14:1323070. [PMID: 38384806 PMCID: PMC10881233 DOI: 10.3389/fonc.2024.1323070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/16/2024] [Indexed: 02/23/2024] Open
Abstract
Cryoablation, as a minimally invasive technology for the treatment of tumors, destroys target tumors with lethal low temperatures. It simultaneously releases a large number of tumor-specific antigens, pro-inflammatory cytokines, and nucleoproteins, known as "danger signals", activating the body's innate and adaptive immune responses. However, tumor cells can promote the inactivation of immune effector cells by reprogramming immune checkpoints, leading to the insufficiency of these antigens to induce an immune response capable of eradicating the tumor. Immune checkpoint blockers rejuvenate exhausted T cells by blocking immune checkpoints that induce programmed death of T cells, and are therefore considered a promising therapeutic strategy to enhance the immune effects of cryoablation. In this review, we provide a detailed explanation of the immunological mechanisms of cryoablation and articulate the theoretical basis and research progress of the treatment of cancer with cryoablation combined with immune checkpoint blockers. Preliminary data indicates that this combined treatment strategy exhibits good synergy and has been proven to be safe and effective.
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Affiliation(s)
- Qi Liu
- Department of Pulmonary and Critical Care Medicine, The Sixth Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
- Navy Clinical College, the Fifth School of Clinical Medicine, Anhui Medical University, Hefei, Anhui, China
| | - Chunyang Zhang
- Department of Pulmonary and Critical Care Medicine, The Sixth Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
- College of Pulmonary and Critical Care Medicine, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
| | - Xuxin Chen
- Department of Pulmonary and Critical Care Medicine, The Sixth Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
- College of Pulmonary and Critical Care Medicine, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
| | - Zhihai Han
- Department of Pulmonary and Critical Care Medicine, The Sixth Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
- Navy Clinical College, the Fifth School of Clinical Medicine, Anhui Medical University, Hefei, Anhui, China
- College of Pulmonary and Critical Care Medicine, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
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Wang Z, Yao X, Wang K, Wang B. TFR1-Mediated Iron Metabolism Orchestrates Tumor Ferroptosis and Immunity in Non-Small Cell Lung Cancer. J Environ Pathol Toxicol Oncol 2024; 43:1-12. [PMID: 38505909 DOI: 10.1615/jenvironpatholtoxicoloncol.2023049084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
This study aimed to investigate the underlying molecular mechanisms of transferrin receptor (TFR1) in non-small cell lung cancer (NSCLC). Histological analysis was performed using hematoxylin-eosin (HE) staining. The number of CD8+ T cell were determined by flow cytometry and immunofluorescence assays. mRNA levels were analyzed by qRT-PCR. Protein expression was detected by western blot. Ferroptosis was detected by using propidium iodide (PI) staining. Xenograft experiment was applied for determining tumor growth. The results showed that interferon (IFN)-γ plus iron dextran (FeDx) induced iron overload and the ferroptosis of NSCLC cells. Moreover, IFN-γ-mediated upregulation of TFR1 promoted ferritinophagy and tumor cell ferroptosis via blocking via blocking ferritin heavy chain 1 (FTH1)/ ferritin light chain (FTL) signaling. However, TFR1 knockout suppressed the ferroptosis of tumor cells. Furthermore, FeDx-mediated iron overload promoted the sensitivity of anti-programmed death ligand 1 (PD-L1) therapies. Clinically, TFR1 was downregulated in NSCLC patients. Low levels of TFR1 predicted decreased CD8+ T cells. Taken together, IFN-γ combined with iron metabolism therapies may provide a novel alternative for NSCLC.
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Affiliation(s)
- Zunqiao Wang
- Department of Thoracic Surgery, Nanjing Chest Hospital, Nanjing 210029, P.R China
| | - Xingkai Yao
- Department of Thoracic Surgery, People's Hospital of Luhe District in Nanjing, Nanjing 210000, P.R China
| | - Keping Wang
- Department of Thoracic Surgery, Nanjing Chest Hospital, Nanjing 210029, P.R China
| | - Bin Wang
- Department of Thoracic Surgery, Nanjing Chest Hospital, Nanjing 210029, P.R China
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Yu ZP, Sun XW, He YP, Gu J, Jin Y. PD-1 monoclonal antibodies enhance the cryoablation-induced antitumor immune response: a breast cancer murine model research. Int J Hyperthermia 2023; 40:2164625. [PMID: 36966808 DOI: 10.1080/02656736.2022.2164625] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023] Open
Abstract
BACKGROUND It has been demonstrated that cryoablation (Cryo) causes specific T-cell immune responses in the body; however, it is not sufficient to prevent tumor recurrence and metastasis. In this report, we evaluated changes in the tumor immune microenvironment (TIME) in distant tumor tissues after Cryo and investigated the immunosuppressive mechanisms that limit the efficacy of Cryo. METHODS Bilateral mammary tumor models were established in mice, and we first observed the dynamic changes in immune cells and cytokines at different time points after Cryo. Then, we confirmed that the upregulation of PD-1 and PD-L1 signaling in the contralateral tumor tissue was closely related to the immunosuppressive state in the TIME at the later stage after Cryo. Finally, we also evaluated the synergistic antitumor effects of Cryo combined with PD-1 monoclonal antibody (mAb) in the treatment of breast cancer (BC) mouse. RESULTS We found that Cryo can stimulate the body's immune response, but it also induces immunosuppression. The elevated PD-1/PD-L1 expression in distant tumor tissues at the later stage after Cryo was closely related to the immunosuppressive state in the TIME but also created the conditions for Cryo combined with PD-1 mAb for BC mouse treatment. Cryo + PD-1 mAb could improve the immunosuppressive state of tumors and enhance the Cryo-induced immune response, thus exerting a synergistic antitumor effect. CONCLUSIONS The PD-1/PD-L1 axis plays an important role in suppressing Cryo-induced antitumor immune responses. This study provides a theoretical basis for Cryo combined with PD-1 mAb therapy in clinical BC patients.
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de Baere T, Bonnet B, Tselikas L, Deschamps F. The percutaneous management of pulmonary metastases. J Med Imaging Radiat Oncol 2023; 67:870-875. [PMID: 37742316 DOI: 10.1111/1754-9485.13588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/03/2023] [Indexed: 09/26/2023]
Abstract
Local treatment of lung metastases has been in the front scene since late 90s when an international registry of thoracic surgery reported a median overall survival of 35 months in resected patients versus 15 months in non-resected patients. Today, other local therapies are available for patients with oligometastatic lung disease, including image guided thermal ablation, such as ablation, microwave ablation, and cryoablation. Image-guided ablation is increasingly offered, and now recommended in guidelines as option to surgery. Today, the size of the target tumour remains the main driver of success and selection of patients with limited tumour size allowing for local tumour control in the range of 90% in most recent and larger series targeting lung metastases up to 3.5 cm. Overall survival exceeding five-years in large series of thermal ablation for lung metastases from colorectal origin are align with outcome of same patients treated with surgical resection. Moreover, thermal ablation in such population allows for one-year chemotherapy holidays in all comers and over 18 months in lung only metastatic patients, allowing for improved patient quality of life and preserving further lines of systemic treatment when needed. Tolerance of thermal ablation is excellent and better than surgery with no lost in respiratory function, allowing for repeated treatment when needed. In the future, it is likely that practice of lung surgery for small oligometastatic lung disease will decrease, and that minimally invasive techniques will replace surgery in such indications. Randomized study will be difficult to obtain as demonstrated by discontinuation of many studies testing the hypothesis of surgery versus observation, or surgery versus SBRT.
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Affiliation(s)
- Thierry de Baere
- Department of Interventional Radiology, Gustave Roussy, Villejuif, France
- University of Paris-Saclay, UFR Médecine Le Kremlin-Bicêtre, Le Kremlin-Bicêtre, France
- Centre d'Investigation Clinique BIOTHERIS, INSERM CIC1428, Villejuif, France
| | - Baptiste Bonnet
- Department of Interventional Radiology, Gustave Roussy, Villejuif, France
| | - Lambros Tselikas
- Department of Interventional Radiology, Gustave Roussy, Villejuif, France
- University of Paris-Saclay, UFR Médecine Le Kremlin-Bicêtre, Le Kremlin-Bicêtre, France
- Centre d'Investigation Clinique BIOTHERIS, INSERM CIC1428, Villejuif, France
| | - Frederic Deschamps
- Department of Interventional Radiology, Gustave Roussy, Villejuif, France
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Sang J, Ye X. Potential biomarkers for predicting immune response and outcomes in lung cancer patients undergoing thermal ablation. Front Immunol 2023; 14:1268331. [PMID: 38022658 PMCID: PMC10646301 DOI: 10.3389/fimmu.2023.1268331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Thermal ablation is a promising alternative treatment for lung cancer. It disintegrates cancer cells and releases antigens, followed by the remodeling of local tumor immune microenvironment and the activation of anti-tumor immune responses, enhancing the overall effectiveness of the treatment. Biomarkers can offer insights into the patient's immune response and outcomes, such as local tumor control, recurrence, overall survival, and progression-free survival. Identifying and validating such biomarkers can significantly impact clinical decision-making, leading to personalized treatment strategies and improved patient outcomes. This review provides a comprehensive overview of the current state of research on potential biomarkers for predicting immune response and outcomes in lung cancer patients undergoing thermal ablation, including their potential role in lung cancer management, and the challenges and future directions.
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Affiliation(s)
| | - Xin Ye
- Department of Oncology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Lung Cancer Institute, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Jinan, China
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10
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Liao Y, Chen Y, Liu S, Wang W, Fu S, Wu J. Low-dose total body irradiation enhances systemic anti-tumor immunity induced by local cryotherapy. J Cancer Res Clin Oncol 2023; 149:10053-10063. [PMID: 37261526 DOI: 10.1007/s00432-023-04928-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 05/23/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Strategies that restore the immune system's ability to recognize malignant cells have yielded clinical benefits but only in some patients. Tumor cells survive cryotherapy and produce a vast amount of antigens to trigger innate and adaptive responses. However, because tumor cells have developed immune escape mechanisms, cryotherapy alone may not be enough to induce a significant immune response. METHODS The mice were randomly divided into four groups: Group A: low-dose total body irradiation combined with cryotherapy (L-TBI+cryo); Group B: cryotherapy (cryo); Group C: low-dose total body irradiation(L-TBI); Group D: control group (Control). The tumor growth, recurrence, and survival time of mice in each group were compared and the effects of different treatments on systemic anti-tumor immunity were explored. RESULTS L-TBI in conjunction with cryotherapy can effectively control tumor regrowth, inhibit tumor lung metastasis, extend the survival time of mice, and stimulate a long-term protective anti-tumor immune response to resist the re-challenge of tumor cells. The anti-tumor mechanism of this combination therapy may be related to the stimulation of inflammatory factors IFN-γ and IL-2, as well as an increase in immune effector cells (CD8+ T cells) and a decrease in immunosuppressive cells (MDSC, Treg cells) in the spleen or tumor tissue. CONCLUSIONS We present unique treatment options for enhancing the immune response caused by cryotherapy, pointing to the way forward for cancer treatment.
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Affiliation(s)
- Yin Liao
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
| | - Yao Chen
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
| | - Shuya Liu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
| | - Weizhou Wang
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
| | - Shaozhi Fu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
| | - Jingbo Wu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China.
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11
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Wang X, Hou Y, Liu Q, Zhou T, Rao W. Cryoablation combined with a clinical Chinese medicine for the treatment of lung cancer. Cryobiology 2023; 112:104559. [PMID: 37451669 DOI: 10.1016/j.cryobiol.2023.104559] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
Cryoablation has been clinically applied to the treatment of lung cancer, but cryoablation has the problem of incomplete tumor killing when the freezing dose is not enough, which may lead to tumor recurrence or metastasis. Therefore, cryoablation combined with other therapeutic options is usually suggested to achieve a complete cure for lung cancer. Clinical practices have shown that traditional Chinese medicine (TCM) treatment can improve the quality of life of patients with advanced lung cancer and prolong the postoperative survival time. However, the mechanism of the synergistic effect of Chinese medicine and cryotherapy, and the optimal treatment plan have not been clarified so far. Therefore, the effect of TCM particles on ice crystal growth and phase transition during cooling was investigated. In addition, we explored the optimized concentration and combination treatment sequence of TCM (lung care formula) and validated the optimal treatment protocol by establishing a mouse model of non-small cell lung cancer (NSCLC). In general, cryoablation combined with TCM is a useful treatment for lung cancer, which can effectively solve the problem of tumor recurrence after cryoablation.
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Affiliation(s)
- Xiaoshuai Wang
- CAS Key Laboratory of Cryogenics, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing, 100190, China; Beijing Key Lab of Cryo-Biomedical Engineering, Beijing, 100190, China; School of Future Technology, University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Yi Hou
- CAS Key Laboratory of Cryogenics, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing, 100190, China; Beijing Key Lab of Cryo-Biomedical Engineering, Beijing, 100190, China; School of Future Technology, University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Qiongni Liu
- Beijing University of Chinese Medicine, Beijing, 100029, China; Oncology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, 100078, China.
| | - Tian Zhou
- Beijing University of Chinese Medicine, Beijing, 100029, China.
| | - Wei Rao
- CAS Key Laboratory of Cryogenics, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing, 100190, China; Beijing Key Lab of Cryo-Biomedical Engineering, Beijing, 100190, China; School of Future Technology, University of Chinese Academy of Sciences, Beijing, 100049, China.
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12
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Velez A, DeMaio A, Sterman D. Cryoablation and immunity in non-small cell lung cancer: a new era of cryo-immunotherapy. Front Immunol 2023; 14:1203539. [PMID: 37671163 PMCID: PMC10475831 DOI: 10.3389/fimmu.2023.1203539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 07/31/2023] [Indexed: 09/07/2023] Open
Abstract
Despite remarkable advances in tumor response and patient survival in the past decade, systemic immunotherapies for lung cancer result in an objective response in only around half of patients treated. On the basis of this limitation, combination strategies are being investigated to improve response rates. Cryoablation has been proposed as one such technique to induce immunogenic cell death and synergize with systemic immunotherapies, including immune checkpoint inhibitors. Cryoablation has been traditionally delivered percutaneously with imaging guidance although recent technological advances allow for bronchoscopic delivery. Herein, we review the pre-clinical and clinical evidence for the use of cryoablation in non-small cell lung cancer and potential induction of anti-tumor immunity. We highlight ongoing studies involving this approach and propose areas of future investigation.
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Affiliation(s)
- Antonio Velez
- Pulmonary Oncology Research Team (New York University (NYU) PORT), Section of Interventional Pulmonology, Division of Pulmonary, Critical Care and Sleep Medicine, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, United States
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13
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Ren J, Ren J, Wang K, Tan Q. The consideration of surgery on primary lesion of advanced non-small cell lung cancer. BMC Pulm Med 2023; 23:118. [PMID: 37060050 PMCID: PMC10103432 DOI: 10.1186/s12890-023-02411-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/31/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND Numerous reports have shown that medical treatment confers excellent survival benefits to patients with advanced stage IV non-small cell lung cancer (NSCLC). However, the implications of surgery for primary lesions as palliative treatment remain inconclusive. METHODS We retrospectively extracted clinical data from the Surveillance, Epidemiology, and End Results Program (SEER) database and selected patients with stage IV NSCLC. Patients were classified into non-surgery and surgery groups, and propensity score matching (PSM) analysis was performed to balance the baseline information. Patients in the surgery group, whose overall survival (OS) was longer than the median survival time of those in the non-surgery group, were deemed to benefit from surgery. We evaluated the efficacy of three surgical techniques, namely, local destruction, sub-lobectomy, and lobectomy, on the primary site in the beneficial population. RESULTS The results of Cox regression analyses revealed that surgery was an independent risk factor for both OS (hazard ratio [HR]: 0.441; confidence interval [CI]: 0.426-0.456; P < 0.001) and cancer-specific survival (CSS) (HR: 0397; CI: 0.380-0.414; P < 0.001). Notably, patients who underwent surgery had a better prognosis than those who did not (OS: P < 0.001; CSS: P < 0.001). Moreover, local destruction and sub-lobectomy significantly compromised survival compared to lobectomy in the beneficial group (P < 0.001). After PSM, patients with stage IV disease who underwent lobectomy needed routine mediastinal lymph node clearing (OS: P = 0.0038; CSS: P = 0.039). CONCLUSION Based on these findings, we recommend that patients with stage IV NSCLC undergo palliative surgery for the primary site and that lobectomy plus lymph node resection should be conventionally performed on those who can tolerate the surgery.
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Affiliation(s)
- Jianghao Ren
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, 241 Huaihai Rd, Shanghai, 200030, China
| | - Jiangbin Ren
- Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China
| | - Kan Wang
- The 4Th Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Qiang Tan
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, 241 Huaihai Rd, Shanghai, 200030, China.
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14
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Tan J, Liu T, Fan W, Wei J, Zhu B, Liu Y, Liu L, Zhang X, Chen S, Lin H, Zhang Y, Li J. Anti-PD-L1 antibody enhances curative effect of cryoablation via antibody-dependent cell-mediated cytotoxicity mediating PD-L1 highCD11b + cells elimination in hepatocellular carcinoma. Acta Pharm Sin B 2023; 13:632-647. [PMID: 36873191 PMCID: PMC9978915 DOI: 10.1016/j.apsb.2022.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/15/2022] [Accepted: 07/02/2022] [Indexed: 11/30/2022] Open
Abstract
Cryoablation (CRA) and microwave ablation (MWA) are two main local treatments for hepatocellular carcinoma (HCC). However, which one is more curative and suitable for combining with immunotherapy is still controversial. Herein, CRA induced higher tumoral PD-L1 expression and more T cells infiltration, but less PD-L1highCD11b+ myeloid cells infiltration than MWA in HCC. Furthermore, CRA had better curative effect than MWA for anti-PD-L1 combination therapy in mouse models. Mechanistically, anti-PD-L1 antibody facilitated infiltration of CD8+ T cells by enhancing the secretion of CXCL9 from cDC1 cells after CRA therapy. On the other hand, anti-PD-L1 antibody promoted the infiltration of NK cells to eliminate PD-L1highCD11b+ myeloid cells by antibody-dependent cell-mediated cytotoxicity (ADCC) effect after CRA therapy. Both aspects relieved the immunosuppressive microenvironment after CRA therapy. Notably, the wild-type PD-L1 Avelumab (Bavencio), compared to the mutant PD-L1 atezolizumab (Tecentriq), was better at inducing the ADCC effect to target PD-L1highCD11b+ myeloid cells. Collectively, our study uncovered the novel insights that CRA showed superior curative effect than MWA in combining with anti-PD-L1 antibody by strengthening CTL/NK cell immune responses, which provided a strong rationale for combining CRA and PD-L1 blockade in the clinical treatment for HCC.
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Affiliation(s)
- Jizhou Tan
- Department of Interventional Oncology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.,Department of Stomatology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Ting Liu
- Department of Laboratory Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Traditional, Chinese Medicine, Guangzhou 510120, China.,Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Wenzhe Fan
- Department of Interventional Oncology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Jialiang Wei
- Department of Interventional Oncology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Bowen Zhu
- Department of Interventional Oncology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Yafang Liu
- Department of Stomatology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Lingwei Liu
- Department of Interventional Oncology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiaokai Zhang
- Department of Interventional Oncology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Songling Chen
- Department of Stomatology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Haibiao Lin
- Department of Laboratory Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Traditional, Chinese Medicine, Guangzhou 510120, China.,Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Yuanqing Zhang
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - Jiaping Li
- Department of Interventional Oncology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
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15
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Lv Y, Liu Y, Li K, Liu Z, Zhang T, Duan M, Chen Y, Ma T, Huang G, Huang Z. Nomogram Based on Preoperative Absolute Lymphocyte Count to Predict Local Recurrence in Patients with Non-Small Cell Lung Cancer After Microwave Ablation. J Inflamm Res 2023; 16:1761-1770. [PMID: 37113625 PMCID: PMC10128153 DOI: 10.2147/jir.s402108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Purpose This study aims to investigate the prognostic value of preoperative absolute lymphocyte count (preALC) for non-small cell lung cancer (NSCLC) after microwave ablation (MWA) and build a combined nomograph with clinical features to predict the local recurrence. Patients and Methods A total of 118 NSCLC patients who underwent microwave ablation were enrolled in this study. The median local recurrence-free survival (LRFS) was 35.5 months. Independent prognostic factors obtained by multivariate analysis were included in the prediction model. The prognostic value of the model was assessed by the area under the time-dependent receiver operating characteristic curve (T-AUC). Results Histological subtype and preALC were independent risk factors for local relapse-free survival. According to the time-dependent receiver operating characteristic curve (T-ROC), the optimal cut-off value of preALC was 1.965×109/L, the sensitivity was 0.837, and the specificity was 0.594. The area under the T-ROC curve (AUC) of preALC was 0.703. To establish a nomogram to predict the local recurrence rate of NSCLC after MWA based on the prognostic factors revealed by Cox regression. Conclusion Preoperative lymphocyte count reduction is associated with poor prognosis of NSCLC. The nomogram model combined with preALC can provide a good individualized prediction of local recurrence after microwave ablation.
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Affiliation(s)
- Yonghui Lv
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250000, People’s Republic of China
| | - Yuanwei Liu
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250000, People’s Republic of China
| | - Kaiguo Li
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250000, People’s Republic of China
| | - Zhiling Liu
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250000, People’s Republic of China
| | - Tong Zhang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250000, People’s Republic of China
| | - Mingguang Duan
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250000, People’s Republic of China
| | - Yunchao Chen
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250000, People’s Republic of China
| | - Teng Ma
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250000, People’s Republic of China
| | - Guanghui Huang
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250000, People’s Republic of China
- Correspondence: Guanghui Huang, Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 9677 Jingshi Road, Lixia District, Jinan, Shandong, 250012, People’s Republic of China, Email
| | - Zhaoqin Huang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250000, People’s Republic of China
- Zhaoqin Huang, Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwu Road, Huaiyin District, Jinan, Shandong, 250012, People’s Republic of China, Email
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16
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Kuang G, Zhang Q, Jia J, Yu Y. Freezing biological organisms for biomedical applications. SMART MEDICINE 2022; 1:e20220034. [PMID: 39188743 PMCID: PMC11235656 DOI: 10.1002/smmd.20220034] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 12/07/2022] [Indexed: 08/28/2024]
Abstract
Biological organisms play important roles in human health, either in a commensal or pathogenic manner. Harnessing inactivated organisms or living organisms is a promising way to treat diseases. As two types of freezing, cryoablation makes it simple to inactivate organisms that must be in a non-pathogenic state when needed, while cryopreservation is a facile way to address the problem of long-term storage challenged by living organism-based therapy. In this review, we present the latest studies of freezing biological organisms for biomedical applications. To begin with, the freezing strategies of cryoablation and cryopreservation, as well as their corresponding technical essentials, are illustrated. Besides, biomedical applications of freezing biological organisms are presented, including transplantation, tissue regeneration, anti-infection therapy, and anti-tumor therapy. The challenges and prospects of freezing living organisms for biomedical applications are well discussed. We believe that the freezing method will provide a potential direction for the standardization and commercialization of inactivated or living organism-based therapeutic systems, and promote the clinical application of organism-based therapy.
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Affiliation(s)
- Gaizhen Kuang
- Pharmaceutical Sciences LaboratoryÅbo Akademi UniversityTurkuFinland
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health)Wenzhou InstituteUniversity of Chinese Academy of SciencesWenzhouChina
| | - Qingfei Zhang
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health)Wenzhou InstituteUniversity of Chinese Academy of SciencesWenzhouChina
| | - Jinxuan Jia
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health)Wenzhou InstituteUniversity of Chinese Academy of SciencesWenzhouChina
| | - Yunru Yu
- Pharmaceutical Sciences LaboratoryÅbo Akademi UniversityTurkuFinland
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17
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Shang Y, Li G, Zhang B, Wu Y, Chen Y, Li C, Zhao W, Liu J. Image-guided percutaneous ablation for lung malignancies. Front Oncol 2022; 12:1020296. [PMID: 36439490 PMCID: PMC9685331 DOI: 10.3389/fonc.2022.1020296] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/19/2022] [Indexed: 10/21/2023] Open
Abstract
Image-guided percutaneous lung ablation has proven to be an alternative and effective strategy in the treatment of lung cancer and other lung malignancies. Radiofrequency ablation, microwave ablation, and cryoablation are widely used ablation modalities in clinical practice that can be performed along or combined with other treatment modalities. In this context, this article will review the application of different ablation strategies in lung malignancies.
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Affiliation(s)
- Youlan Shang
- Second Xiangya Hospital, Central South University, Changsha, China
| | - Ge Li
- Xiangya Hospital, Central South University, Changsha, China
| | - Bin Zhang
- Second Xiangya Hospital, Central South University, Changsha, China
| | - Yuzhi Wu
- Second Xiangya Hospital, Central South University, Changsha, China
| | - Yanjing Chen
- Second Xiangya Hospital, Central South University, Changsha, China
| | - Chang Li
- Second Xiangya Hospital, Central South University, Changsha, China
| | - Wei Zhao
- Second Xiangya Hospital, Central South University, Changsha, China
| | - Jun Liu
- Second Xiangya Hospital, Central South University, Changsha, China
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18
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Tian Y, Qi X, Jiang X, Shang L, Xu K, Shao H. Cryoablation and immune synergistic effect for lung cancer: A review. Front Immunol 2022; 13:950921. [PMID: 36389781 PMCID: PMC9647087 DOI: 10.3389/fimmu.2022.950921] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/13/2022] [Indexed: 07/29/2023] Open
Abstract
The preferred treatment for lung cancer is surgical resection, but a large number of patients are not suitable for surgical resection in clinic. CT-guided cryoablation and immunotherapy can play an important role in patients with advanced lung cancer who are ineligible for surgery. CT-guided cryoablation has been widely used in the clinical treatment of lung tumors due to its advantages of less trauma, fewer complications, significant efficacy and rapid recovery. Cryoablation can not only cause tumor necrosis and apoptosis, but also promote the release of tumor-derived autoantigens into the blood circulation, and stimulate the host immune system to produce a good anti-tumor immune effect against primary and metastatic tumors. Since the study of immune checkpoint inhibitors has proved that lung cancer can be an immunotherapeutic response disease, the relationship between cryoablation and immunotherapy of lung cancer has been paid more attention. Therefore, we reviewed the literature on cryoablation for lung cancer, as well as the research progress of cryoablation combined with immunotherapy.
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Affiliation(s)
- Yulong Tian
- Department of Interventional Radiology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xingshun Qi
- Department of Gastroenterology, Northern Theater General Hospital, Shenyang, Liaoning, China
| | - Xin Jiang
- Department of Interventional Radiology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Liqi Shang
- Department of Interventional Radiology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Ke Xu
- Department of Interventional Radiology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Haibo Shao
- Department of Interventional Radiology, The First Hospital of China Medical University, Shenyang, Liaoning, China
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19
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Wei F, Guo R, Yan Y, Lin R, Chen J, Lin Z. Investigation of the efficacy and safety of cryoablation and intra-arterial PD-1 inhibitor in patients with advanced disease not responding to checkpoint inhibitors: An exploratory study. Front Immunol 2022; 13:990224. [PMID: 36211329 PMCID: PMC9537743 DOI: 10.3389/fimmu.2022.990224] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 09/09/2022] [Indexed: 11/26/2022] Open
Abstract
Objective To explore the effectiveness of cryoablation combined with arterial perfusion with programmed cell death protein 1 inhibitors in overcoming immune resistance in advanced solid cancers. Methods In this pilot retrospective study, nine patients with solid cancers were treated with tumour cryoablation and arterial perfusion with programmed cell death protein 1 inhibitors, which had previously proven ineffective. The CIBERSORT software was used to estimate the levels of tumour-infiltrating immune cells in the challenged tumour. Changes in the levels of circulating T cells were assessed using flow cytometry. The primary endpoints were disease control and objective response rates, and the secondary endpoint was safety. Results The nine patients with advanced solid tumours received cryoablation combined with arterial perfusion with programmed cell death protein 1 inhibitors between June and December 2021. The median follow-up time was 5.8 months. We recorded an objective response rate in two patients (22.22%). The best overall responses were partial responses in two patients (22.22%) and one case (11.11%) of stable disease, while six patients (66.67%) presented progressive disease. However, the median overall survival time was not reached. The median progression-free survival was 2.4 months. Treatment-related severe adverse events included one case of abdominal infection and one case of upper gastrointestinal bleeding, which were cured after the intervention. The CIBERSORT software confirmed the importance of cryoablation in regulating tumour-infiltrating immune cells. Thus, macrophage polarisation from the M2 to the M1 phenotype in the challenged tumour and a gradual increase in the levels of circulating CD4+ T cells were observed after administration of the combination therapy. Conclusion Cryoablation combined with arterial perfusion with programmed cell death protein 1 inhibitors has the potential efficacy and safety to overcome immune resistance in patients with advanced solid cancers. The combination therapy leads to macrophage polarisation from the M2 to the M1 phenotype in the challenged tumour to enhance antitumour immunity.
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Affiliation(s)
- Fuqun Wei
- The Department of Interventional Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Rui Guo
- The Department of Interventional Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Yuan Yan
- The Department of Interventional Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Ruixiang Lin
- The Department of Interventional Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Jin Chen
- The Department of Interventional Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Zhengyu Lin
- The Department of Interventional Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Fujian Provincial Key Laboratory of Precision Medicine for Cancer, Fuzhou, Fujian, China
- *Correspondence: Zhengyu Lin,
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20
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Stone E, Leong TL. Contemporary Concise Review 2021: Pulmonary nodules from detection to intervention. Respirology 2022; 27:776-785. [PMID: 35581532 DOI: 10.1111/resp.14296] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/02/2022] [Indexed: 12/11/2022]
Abstract
The US Preventive Task Force (USPSTF) has updated screening criteria by expanding age range and reducing smoking history required for eligibility; the International Lung Screen Trial (ILST) data have shown that PLCOM2012 performs better for eligibility than USPSTF criteria. Screening adherence is low (4%-6% of potential eligible candidates in the United States) and depends upon multiple system and patient/candidate-related factors. Smoking cessation in lung cancer improves survival (past prospective trial data, updated meta-analysis data); smoking cessation is an essential component of lung cancer screening. Circulating biomarkers are emerging to optimize screening and early diagnosis. COVID-19 continues to affect lung cancer treatment and screening through delays and disruptions; specific operational challenges need to be met. Over 70% of suspected malignant lesions develop in the periphery of the lungs. Bronchoscopic navigational techniques have been steadily improving to allow greater accuracy with target lesion approximation and therefore diagnostic yield. Fibre-based imaging techniques provide real-time microscopic tumour visualization, with potential diagnostic benefits. With significant advances in peripheral lung cancer localization, bronchoscopically delivered ablative therapies are an emerging field in limited stage primary and oligometastatic disease. In advanced stage lung cancer, small-volume samples acquired through bronchoscopic techniques yield material of sufficient quantity and quality to support clinically relevant biomarker assessment.
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Affiliation(s)
- Emily Stone
- Department of Thoracic Medicine and Lung Transplantation, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia.,School of Clinical Medicine, UNSW, Sydney, New South Wales, Australia.,School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Tracy L Leong
- Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, Victoria, Australia.,Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
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21
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Pang H, Hu K, Li F, Duan H, Chen Y, Hu Y, Wang D, Jiang M. Untargeted metabolomics profiling in a mouse model of lung cancer treated with thermal ablation. Bioengineered 2022; 13:11258-11268. [PMID: 35481548 PMCID: PMC9208470 DOI: 10.1080/21655979.2022.2065742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Thermal ablation is widely used in the treatment of lung cancer and is beneficial for the overall survival of patients in clinic. However, there is barely a priority in which ablation system should be chosen under different periods of tumor progression in lung cancer. The present study investigated different modes of thermal ablation systems in mice with transplanted Lewis lung carcinoma tumors and their various biological effects in local regions using untargeted metabolomics. The results showed that thermal ablation could significantly suppress tumor growth and the differentially expressed metabolites of tumors after ablation relative to untreated tumors concentrated on organic compounds, organic acids and derivatives, nucleosides, nucleotides, and lipids. The upregulated metabolites indicated an inflammatory reaction in the ablation groups at an early stage after ablation. Steroid hormone and tryptophan metabolism, which are associated with immune responses, were modulated after both cryoablation and hyperthermal ablation. Characteristically, the results also indicated that cryoablation suppressed glucose oxidation and carbohydrate metabolism of tumor, while hyperthermal ablation suppressed lipid metabolism of tumor. In conclusion, thermal ablation could inhibit tumor growth under either freezing or heating modes with characteristic different biological effects on tumors.
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Affiliation(s)
- Haoyue Pang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Kaiwen Hu
- Department of Oncology, Dongfang Hospital Beijing University of Chinese Medicine, Beijing, China
| | - Fuyao Li
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Hua Duan
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Yu Chen
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Yaqi Hu
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Dan Wang
- Department of Hemooncology, Dongzhimen Hospital Beijing University of Chinese Medicine, Beijing, China
| | - Min Jiang
- Department of Oncology, Dongfang Hospital Beijing University of Chinese Medicine, Beijing, China
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22
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[Current Status and Progress of Thermal Ablation Combined with Immunotherapy for Lung Tumors]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2022; 25:266-271. [PMID: 35477191 PMCID: PMC9051299 DOI: 10.3779/j.issn.1009-3419.2022.102.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Recent studies have shown that tumor immune microenvironment is closely related to tumor progression, metastasis, recurrence and response to treatment. Some immunotherapies also offer hope for cancer patients. However, the efficacy of tumor immunotherapy is uncertain and has some side effects. In order to enhance its efficacy, tumor immunotherapy combined with tumor thermal ablation has been studied. Thermal ablation has the advantages of minimally invasive, rapid recovery, safety, fewer complications, conformation, reliable effect, repeatable, low cost, and has become the fourth tumor treatment measure after surgery, radiotherapy, and drug therapy. It can directly kill tumor cells and modulate the immune system through a variety of mechanisms, although the corresponding mechanisms are not well understood, but combined tumor immunotherapy has been proposed to treat several solid malignancies. In this review, the current status and progress of thermal ablation combined with immunotherapy for lung tumor were reviewed, and further studies on the efficacy and safety of thermal ablation combined with immunotherapy were expected.
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Goizueta AA, Casal RF. Bronchoscopic Lung Nodule Ablation. CURRENT PULMONOLOGY REPORTS 2022. [DOI: 10.1007/s13665-022-00287-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Li X, Xu J, Gu X, Chen L, Wu Q, Li H, Bai H, Yang J, Qian J. Case Report: Antiangiogenic Therapy Plus Immune Checkpoint Inhibitors Combined With Intratumoral Cryoablation for Hepatocellular Carcinoma. Front Immunol 2021; 12:740790. [PMID: 34733279 PMCID: PMC8559549 DOI: 10.3389/fimmu.2021.740790] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/04/2021] [Indexed: 12/12/2022] Open
Abstract
Background Hepatocellular carcinoma (HCC) is a common gastrointestinal malignancy with high incidence and poor prognosis. Common treatment methods include surgery, transcatheter arterial chemoembolization (TACE), ablation, and targeted therapy. In recent years, combination treatment with antiangiogenic therapy and immune checkpoint inhibitors has made great progress in the treatment of advanced HCC. Here, we report the case of a patient with HCC who achieved a durable benefit from anti-vascular therapy and immune checkpoint inhibitors combined with intratumoral cryoablation. Main Body A 38-year-old male patient initially presented with severe abdominal pain that was identified as an HCC rupture and hemorrhage by computed tomography (CT). The patient underwent emergency surgery and postoperative pathology confirmed HCC. The patient received prophylactic TACE after surgery. Unfortunately, three months after surgery, the patient developed multiple liver metastases. Subsequently, he received systemic anti-vascular therapy and immune checkpoint inhibitors combined with intratumoral cryoablation. After treatment, the patient achieved extensive tumor necrosis and the disease was effectively controlled. Conclusions Anti-angiogenic therapy and immune checkpoint inhibitors combined with cryoablation can induce a powerful and effective systemic anti-tumor immune response, which is worthy of further research.
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Affiliation(s)
- Xin Li
- Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Jiahua Xu
- Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Xiaoqiang Gu
- Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Ling Chen
- Department of Oncology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Qing Wu
- Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Hongwei Li
- Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Haoran Bai
- Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Jinzu Yang
- Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
| | - Jianxin Qian
- Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Shanghai, China
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Zhang T, Chen J, Niu L, Liu Y, Ye G, Jiang M, Qi Z. Clinical Safety and Efficacy of Locoregional Therapy Combined with Adoptive Transfer of Allogeneic γδ T Cells for Advanced Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma. J Vasc Interv Radiol 2021; 33:19-27.e3. [PMID: 34600129 DOI: 10.1016/j.jvir.2021.09.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 09/11/2021] [Accepted: 09/17/2021] [Indexed: 01/10/2023] Open
Abstract
PURPOSE To investigate the safety and efficacy of locoregional therapy plus adoptive transfer of allogeneic gamma delta (γδ) T cells for patients with hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). METHODS Thirty patients with HCC and 29 patients with ICC were randomly assigned to receive locoregional therapy (HCC, Group A, n = 15; ICC, Group C, n = 15) or locoregional therapy plus γδ T cell therapy (HCC, Group B, n = 15; ICC, Group D, n = 14). Groups A and C only received locoregional ablation (cryoablation or irreversible electroporation), whereas Groups B and D received locoregional therapy followed by adoptive transfer of allogeneic γδ T cells. The primary endpoints were safety, distant progression-free survival (PFS), local PFS, and overall survival (OS). RESULTS The median distant PFS was significantly longer in the combined treatment groups than the locoregional treatment groups (HCC: 8 vs 4 months, P = .04; ICC: 8 vs 4 months, P = .021). There was no significant difference in local PFS between the 2 treatment modalities. HCC patients in the combined treatment group had a longer OS (median OS: 13 vs 8 months, P = .029). However, there was no significant difference in OS in ICC patients between the 2 treatment modalities (median OS: 9.5 vs 8 months, P = .546). All adverse events were manageable with no significant difference in incidence between groups. CONCLUSIONS The novel combination of locoregional ablation with adoptive transfer of allogeneic γδ cells was safe, with encouraging clinical efficacy against HCC and ICC.
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Affiliation(s)
| | - Jibing Chen
- Fuda Cancer Hospital of Jinan University, Guangzhou, China
| | - Lizhi Niu
- Fuda Cancer Hospital of Jinan University, Guangzhou, China
| | - Yu Liu
- Medical College of Guangxi University, Nanning, China
| | - Guangbin Ye
- Medical College of Guangxi University, Nanning, China; Youjiang Medical University for Nationalities, Baise, China
| | - Minli Jiang
- Medical College of Guangxi University, Nanning, China
| | - Zhongquan Qi
- Medical College of Guangxi University, Nanning, China.
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Zheng X, Yuan H, Gu C, Yang C, Xie F, Zhang X, Xu B, Sun J. Transbronchial lung parenchyma cryoablation with a novel flexible cryoprobe in an in vivo porcine model. Diagn Interv Imaging 2021; 103:49-57. [PMID: 34593335 DOI: 10.1016/j.diii.2021.08.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/16/2021] [Accepted: 08/31/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the feasibility and safety of transbronchial cryoablation with a novel flexible cryoprobe using nitrogen as the refrigerant in an in vivo porcine model of lung parenchyma. MATERIALS AND METHODS A novel flexible cryoprobe using nitrogen as the refrigerant was used for transbronchial cryoablation of lung parenchyma in six normal female pigs. The cryoprobe was delivered to the distal bronchus in the bilateral porcine lungs via the bronchoscopic working channel under virtual bronchoscopy guidance. The position was confirmed with real-time computed tomography (CT). The whole procedure included two freeze-thaw cycles (15 min and 2 min, respectively). CT images were obtained during cryoablation and at 24 h, one week, two weeks and four weeks after the treatment to assess the effectiveness and safety of the procedure. Ablation zone tissue samples were obtained at 24 h and four weeks after the cryoablation for further histopathological analysis. RESULTS All ablation procedures (12/12; 100%) were performed successfully. No major complications occurred during the procedure or the observation period. The ablation zones were clearly depicted on CT with a maximal ablation zone volume at 24 h (21.88 ± 12.61 [SD] cm3) compared to 3.64 ± 2.06 (SD) cm3 and 10.73 ± 3.84 (SD) cm3 at the end of the 1st and 2nd freeze-thaw cycles, respectively (P < 0.001). Histopathological analysis revealed that a coagulative necrotic zone was formed along the target bronchus, with obvious vascular occlusion and hemorrhage 24 h after treatment. The lesions gradually formed fibrosis after four weeks. CONCLUSION The novel flexible bronchoscopy-guided cryoablation is a feasible, safe and effective modality in an in vivo porcine model of peripheral normal lung parenchyma, suggesting potential capabilities for the treatment of peripheral lung cancer in humans.
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Affiliation(s)
- Xiaoxuan Zheng
- Department of Respiratory Endoscopy, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China; Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China; Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China
| | - Haibin Yuan
- Department of Emergency, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China
| | - Chuanjia Gu
- Department of Respiratory Endoscopy, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China; Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China; Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China
| | - Chi Yang
- Research and Development Department, AccuTarget MediPharma (Shanghai) Co., Ltd., 201318 Shanghai, China; School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, 200093 Shanghai, China
| | - Fangfang Xie
- Department of Respiratory Endoscopy, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China; Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China; Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China
| | - Xueyan Zhang
- Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China
| | - Binkai Xu
- Research and Development Department, AccuTarget MediPharma (Shanghai) Co., Ltd., 201318 Shanghai, China; School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, 200093 Shanghai, China
| | - Jiayuan Sun
- Department of Respiratory Endoscopy, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China; Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China; Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China.
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Rangamuwa K, Leong T, Weeden C, Asselin-Labat ML, Bozinovski S, Christie M, John T, Antippa P, Irving L, Steinfort D. Thermal ablation in non-small cell lung cancer: a review of treatment modalities and the evidence for combination with immune checkpoint inhibitors. Transl Lung Cancer Res 2021; 10:2842-2857. [PMID: 34295682 PMCID: PMC8264311 DOI: 10.21037/tlcr-20-1075] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 11/26/2020] [Indexed: 12/12/2022]
Abstract
Lung cancer is the leading cause of cancer death worldwide, with approximately 1.6 million cancer related deaths each year. Prognosis is best in patients with early stage disease, though even then five-year survival is only 55% in some groups. Median survival for advanced non-small cell lung cancer (NSCLC) is 8–12 months with conventional treatment. Immune checkpoint inhibitor (ICI) therapy has revolutionised the treatment of NSCLC with significant long-term improvements in survival demonstrated in some patients with advanced NSCLC. However, only a small proportion of patients respond to ICI, suggesting the need for further techniques to harness the potential of ICI therapy. Thermal ablation utilizes the extremes of temperature to cause tumour destruction. Commonly used modalities are radiofrequency ablation (RFA), cryoablation and microwave ablation (MWA). At present thermal ablation is reserved for curative-intent therapy in patients with localized NSCLC who are unable to undergo surgical resection or stereotactic ablative body radiotherapy (SABR). Limited evidence suggests that thermal ablative modalities can upregulate an anticancer immune response in NSCLC. It is postulated that thermal ablation can increase tumour antigen release, which would initiate and upregulated steps in the cancer immunity cycle required to elicit an anticancer immune response. This article will review the current thermal ablative techniques and their ability to modulate an anti-cancer immune response with a view of using thermal ablation in conjunction with ICI therapy.
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Affiliation(s)
- Kanishka Rangamuwa
- Department of Respiratory Medicine, Royal Melbourne Hospital, Melbourne, Australia.,Department of Medicine (RMH), University of Melbourne, Parkville, Australia
| | - Tracy Leong
- Department of Respiratory Medicine, Austin Hospital, Heidelberg, Victoria, Australia
| | - Clare Weeden
- Personalised Oncology Division, Walter Eliza Hall institute, Melbourne, Australia
| | | | - Steven Bozinovski
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Michael Christie
- Department of Pathology, Royal Melbourne Hospital, Melbourne, Australia
| | - Tom John
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Phillip Antippa
- Department of Thoracic Surgery, Royal Melbourne Hospital, Melbourne, Australia
| | - Louis Irving
- Department of Respiratory Medicine, Royal Melbourne Hospital, Melbourne, Australia
| | - Daniel Steinfort
- Department of Respiratory Medicine, Royal Melbourne Hospital, Melbourne, Australia.,Department of Medicine (RMH), University of Melbourne, Parkville, Australia
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Genshaft SJ, Suh RD, Abtin F, Baerlocher MO, Dariushnia SR, Devane AM, Himes E, Lisberg A, Padia S, Patel S, Yanagawa J. Society of Interventional Radiology Quality Improvement Standards on Percutaneous Ablation of Non-Small Cell Lung Cancer and Metastatic Disease to the Lungs. J Vasc Interv Radiol 2021; 32:1242.e1-1242.e10. [PMID: 34000388 DOI: 10.1016/j.jvir.2021.04.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/19/2021] [Accepted: 04/27/2021] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To provide guidance on quality improvement thresholds for outcomes and complications of image-guided thermal ablation for the treatment of early stage non-small cell lung cancer, recurrent lung cancer, and metastatic disease. MATERIALS AND METHODS A multidisciplinary writing group conducted a comprehensive literature search to identify studies on the topic of interest. Data were extracted from relevant studies and thresholds were derived from a calculation of 2 standard deviations from the weighted mean of each outcome. A modified Delphi technique was used to achieve consensus agreement on the thresholds. RESULTS Data from 29 studies, including systematic reviews and meta-analyses, retrospective cohort studies, and single-arm trials were extracted for calculation of the thresholds. The expert writing group agreed on thresholds for local control, overall survival and adverse events associated with image-guided thermal ablation. CONCLUSION SIR recommends utilizing the indicator thresholds to review and assess the efficacy of ongoing quality improvement programs. When performance falls above or below specific thresholds, consideration of a review of policies and procedures to assess for potential causes, and to implement changes in practices, may be warranted.
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Affiliation(s)
- Scott J Genshaft
- Department of Radiologic Sciences, David Geffen School of Medicine at University of California, Los Angeles, California.
| | - Robert D Suh
- Department of Radiology, David Geffen School of Medicine at University of California, Los Angeles, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - Fereidoun Abtin
- Department of Radiology, Thoracic and Interventional Section, David Geffen School of Medicine at University of California, Los Angeles
| | | | - Sean R Dariushnia
- Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-Guided Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - A Michael Devane
- Department of Radiology, Prisma Health, University of South Carolina School of Medicine Greenville, Greenville, South Carolina
| | | | - Aaron Lisberg
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Siddharth Padia
- Department of Radiology, Section of Interventional Radiology, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Sheena Patel
- Society of Interventional Radiology, Fairfax, Virginia
| | - Jane Yanagawa
- Division of Thoracic Surgery, David Geffen School of Medicine at University of California, Los Angeles, California
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Zhou M, Bui N, Lohman M, van de Rjin M, Hwang G, Ganjoo K. Long-Term Remission with Ipilimumab/Nivolumab in Two Patients with Different Soft Tissue Sarcoma Subtypes and No PD-L1 Expression. Case Rep Oncol 2021; 14:459-465. [PMID: 33790767 PMCID: PMC7991270 DOI: 10.1159/000512828] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/27/2020] [Indexed: 12/16/2022] Open
Abstract
Checkpoint inhibitor therapy has been shown to improve outcomes in multiple solid malignancies; however, data are limited in soft tissue sarcoma. We present two cases of patients with advanced soft tissue sarcoma of different subtypes (dedifferentiated liposarcoma and myxofibrosarcoma) with zero percent PD-L1 expression by immunohistochemistry who were treated with ipilimumab and nivolumab followed by maintenance nivolumab. Both patients had failed multiple lines of systemic treatment and experienced long-term remission after starting ipilimumab and nivolumab. Genetic testing revealed that no genetic mutations were found in common between the two cases. One patient received concurrent cryoablation, which may have sensitized his tumor to immunotherapy. Checkpoint inhibitor therapy may improve outcomes in soft tissue sarcoma regardless of PD-L1 status, especially when combined with cryoablation. Studies are needed to evaluate whether treatment response varies by sarcoma subtype and what molecular markers can be used to guide patient selection.
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Affiliation(s)
- Maggie Zhou
- Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Nam Bui
- Department of Medicine (Oncology), Stanford University School of Medicine, Stanford, California, USA
| | - Marta Lohman
- Department of Medicine (Oncology), Stanford University School of Medicine, Stanford, California, USA
| | - Matt van de Rjin
- Department of Pathology, Stanford University, Stanford, California, USA
| | - Gloria Hwang
- Department of Radiology, Stanford University School of Medicine, Stanford, California, USA
| | - Kristen Ganjoo
- Department of Medicine (Oncology), Stanford University School of Medicine, Stanford, California, USA
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30
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Barut B, Yalçın CÖ, Demirbaş Ü. The water soluble Zn(II) and Mg(II) phthalocyanines: Synthesis, photochemical, DNA photodamage and PDT effects against A549 cells. J Photochem Photobiol A Chem 2021. [DOI: 10.1016/j.jphotochem.2020.112946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Yang W, An Y, Li Q, Liu C, Zhu B, Huang Q, Zhao M, Yang F, Feng H, Hu K. Co-ablation versus cryoablation for the treatment of stage III-IV non-small cell lung cancer: A prospective, noninferiority, randomized, controlled trial (RCT). Thorac Cancer 2020; 12:475-483. [PMID: 33319493 PMCID: PMC7882381 DOI: 10.1111/1759-7714.13779] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 12/24/2022] Open
Abstract
Background This study compared a co‐ablation (CA) system, which is a novel ablation device, with an argon‐helium cryoablation (AHC) system. We aimed to compare the efficacy and safety of CA and AHC for the treatment of stage III–IV non‐small cell lung cancer (NSCLC). Methods We conducted a multicenter randomized controlled trial (RCT) to determine whether CA was noninferior to AHC. The primary efficacy endpoints were the iceball coverage rate (ICR) and the disease control rate (DCR) one month after treatment. Noninferiority was declared if the lower limit of two‐sided 95% confidence interval (CI) was less than 10%. The ICR and DCR were identified by logistic regression. Treatment safety was assessed. Results A total of 81 patients underwent randomization (41 assigned to the CA and 40 assigned to the AHC groups)and transthoracic ablation. The ICRs in the CA and AHC groups were 99.24% ± 2.18% and 98.66% ± 3.79%, respectively. Central lesions were associated with an increased risk of an incomplete ICR. The DCRs in the CA and AHC groups were 97.6% and 95%, respectively. A smaller lesion area in the CA group was significantly correlated with a better DCR. The rate of complications was 29.26% in the CA group and 30% in the AHC group. (P = 0.943). There was less probe usage per patient in the CA group. Conclusions We determined that CA is noninferior to AHC in terms of efficacy and safety for the treatment of stage III–IV NSCLC. A smaller lesion area in the CA group was significantly correlated with a better DCR. Key points CA was noninferior to AHC for stage III–IV NSCLC.
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Affiliation(s)
- Wuwei Yang
- Department of Tumor Minimally Invasive Treatment, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yonghui An
- Department of Oncology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Quanwang Li
- Oncology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Chuanbo Liu
- Oncology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Baorang Zhu
- Department of Tumor Minimally Invasive Treatment, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Qianfu Huang
- Hygea Medical Technology Co., Ltd., Beijing, China
| | - Mengfei Zhao
- Hygea Medical Technology Co., Ltd., Beijing, China
| | - Fei Yang
- Hygea Medical Technology Co., Ltd., Beijing, China
| | - Huasong Feng
- Department of Respiratory Medicine, The Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Kaiwen Hu
- Oncology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
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Steinfort DP, Herth FJF. Bronchoscopic treatments for early-stage peripheral lung cancer: Are we ready for prime time? Respirology 2020; 25:944-952. [PMID: 32643221 DOI: 10.1111/resp.13903] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/29/2020] [Accepted: 06/10/2020] [Indexed: 12/13/2022]
Abstract
Lung cancer is the leading cause of cancer-related death worldwide and surgical lobectomy remains the preferred therapy for patients with early-stage NSCLC. Medical comorbidities and advanced age preclude resection in many patients and minimally invasive ablative therapies are needed for treatment. Stereotactic ablative radiation is established as an effective modality in this patient group, although may be contraindicated in some patients with prior radiation exposure, comorbidities or centrally positioned tumours. Percutaneous ablative methods are available, although are frequently associated with significant complications. Numerous endoscopic ablative techniques are under evaluation. With a more favourable safety profile and the ability to provide diagnosis and staging information potentially within a single procedure, there is a strong rationale for development of bronchoscopic ablative modalities. In the following article, the authors aim to explore the role bronchoscopic ablation may play in treatment of peripheral lung tumours, and to describe a pathway to establishing these modalities as part of routine care. The current status of several bronchoscopic ablative options is discussed in detail.
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Affiliation(s)
- Daniel P Steinfort
- Department of Respiratory Medicine, Royal Melbourne Hospital, Melbourne, VIC, Australia.,Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Felix J F Herth
- Department of Pneumology and Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRCH), German Center for Lung Research, Heidelberg, Germany
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Lugnani F, Zhao JG. Translation of Cryobiological Techniques to Socially Economically Deprived Populations—Part 2: Cryosurgery. J Med Device 2020. [DOI: 10.1115/1.4045836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
AbstractCold and cryogenic temperatures are used for treating cancer and other pathological conditions in various fields of medicine. Cryosurgery, which resides at the interface of medicine and engineering, has attracted the interest of engineers, scientists, and medical doctors. Recently, particularly since the end of the 1980s, technological developments in cryotherapy equipment and enormous advances in imaging techniques, such as computed tomography and ultrasonography, have allowed surgeons and interventional radiologists to precisely guide cryogenic probes into tumors while avoiding damage to surrounding tissues. Extensive studies have allowed us to conclude that the use of cryogenics facilitates the successful treatment of solid tumors in various organs such as lung, liver, bones, kidneys, prostate, etc. Its simplicity of use, effectiveness, low cost, and limited demand on hospital infrastructure and personnel have made cryosurgery particularly suitable for the treatment of patients of socio-economically deprived populations.
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Affiliation(s)
- Franco Lugnani
- Hippocrates Doo, Brezec pri Divaci 9a, Divaca 6215, Slovenia
| | - John Guojiang Zhao
- Asia-Pacific Institute for Biomedical Research, 28 Connaught Road West, Hong Kong, China
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Palussière J, Catena V, Lagarde P, Cousin S, Cabart M, Buy X, Chomy F. Primary tumors of the lung: should we consider thermal ablation as a valid therapeutic option? Int J Hyperthermia 2019; 36:46-52. [DOI: 10.1080/02656736.2019.1647351] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
| | | | | | - Sophie Cousin
- Oncology Department, Institut Bergonié, Bordeaux, France
| | | | - Xavier Buy
- Imaging Department, Institut Bergonié, Bordeaux, France
| | - François Chomy
- Oncology Department, Institut Bergonié, Bordeaux, France
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35
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Kolbas I, Evman S, Tezel C, Citak S, Kanbur Metin S, Alpay L, Kiral H, Baysungur V. Spontaneous pneumothorax in the elderly: a sign of a malignancy? Asian Cardiovasc Thorac Ann 2019; 27:294-297. [PMID: 30754986 DOI: 10.1177/0218492319831840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Spontaneous pneumothorax usually occurs as a result of rupture of a subpleural bleb or emphysematous bulla. Spontaneous pneumothorax, which is more common in younger age groups, might be the first sign of pulmonary malignancy, especially when it manifests in older patients. METHODS Data of all patients who were treated for spontaneous pneumothorax in our clinic between June 2013 and June 2017 were examined retrospectively. The demographic characteristics, diagnostic methods, pathologic subtypes, and treatment protocols applied in patients diagnosed with malignancy during the treatment period were investigated. RESULTS Out of 1187 patients, 9 (0.8%) had incidental pulmonary malignancies. Metastatic lung cancer was detected in 2 of 9 patients, while primary lung cancer was detected in the other 7. Six patients were operated on and the other 3 were referred for oncologic treatment for various reasons. CONCLUSIONS We suggest that cases of spontaneous pneumothorax in advanced age should be evaluated in a more detailed fashion, and further investigations should be carried out with suspicion of an underlying pulmonary malignancy.
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Affiliation(s)
- Ilker Kolbas
- 1 Thoracic Surgery Clinic, University of Health Sciences, Istanbul Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Serdar Evman
- 2 Thoracic Surgery Clinic, University of Health Sciences, Sureyyapasa Training and Research Hospital, Istanbul, Turkey
| | - Cagatay Tezel
- 2 Thoracic Surgery Clinic, University of Health Sciences, Sureyyapasa Training and Research Hospital, Istanbul, Turkey
| | - Sevinc Citak
- 2 Thoracic Surgery Clinic, University of Health Sciences, Sureyyapasa Training and Research Hospital, Istanbul, Turkey
| | - Serda Kanbur Metin
- 2 Thoracic Surgery Clinic, University of Health Sciences, Sureyyapasa Training and Research Hospital, Istanbul, Turkey
| | - Levent Alpay
- 2 Thoracic Surgery Clinic, University of Health Sciences, Sureyyapasa Training and Research Hospital, Istanbul, Turkey
| | - Hakan Kiral
- 2 Thoracic Surgery Clinic, University of Health Sciences, Sureyyapasa Training and Research Hospital, Istanbul, Turkey
| | - Volkan Baysungur
- 2 Thoracic Surgery Clinic, University of Health Sciences, Sureyyapasa Training and Research Hospital, Istanbul, Turkey
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