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Zaarour Y, Derbel H, Tran C, Saccentia L, Longère B, Blain M, Amaddeo G, Luciani A, Kobeiter H, Tacher V. Evaluation of a new beads reflux control microcatheter in drug-eluting bead transarterial chemoembolization. RESEARCH IN DIAGNOSTIC AND INTERVENTIONAL IMAGING 2024; 10:100048. [PMID: 39077730 PMCID: PMC11265494 DOI: 10.1016/j.redii.2024.100048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/01/2024] [Indexed: 07/31/2024]
Abstract
Rationale and objectives A new microcatheter was recently developed claiming to reduce beads reflux in drug-eluting bead transarterial chemoembolization (DEB-TACE). The aim of this study was to compare the reflux control microcatheter ability versus a standard microcatheter for TACE treatment in patients with hepatocellular carcinoma. Material and methods Patients were prospectively included between November 2017 and February 2022. They received a DEB-TACE treatment with charged radiopaque beads using standard microcatheters or the SeQure reflux control microcatheter (Guerbet, France) and were assigned respectively to a control and a test group. Beads distribution mismatch was evaluated between the targeted territory on treatment planning CBCT and beads' spontaneous opacities on the post-intervention CBCT and the 1-month CT scanner. Results Twenty-three patients (21 men, median age 64 years [12.5 years]) with 37 hepatocellular carcinoma nodules were treated. The control group consisted of 13 patients - 19 nodules, while the test group included ten patients - 18 nodules. Non target embolization (NTE) was found in 20 % (2/10) of patients in the test group and 85 % (11/13) in the control group. NTE involved only an adjacent segment in the test group while it affected the adjacent biliary sector or even the contralateral liver lobe in the control group. No complication linked to NTE was found in the test group, while it led to one case of ischemic cholangitis and another case of biloma in the control group. Conclusion The reflux control microcatheter may be efficient in reducing NTE and thus eventual adverse events in comparison to standard of care end-hole microcatheters.
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Affiliation(s)
- Youssef Zaarour
- Department of Radiology, CHU Henri-Mondor, Assistance publique – hôpitaux de Paris (AP-HP), 1, rue Gustave-Eiffel, 94010 Créteil, France
| | - Haytham Derbel
- Department of Radiology, CHU Henri-Mondor, Assistance publique – hôpitaux de Paris (AP-HP), 1, rue Gustave-Eiffel, 94010 Créteil, France
| | - Charles Tran
- Université Paris-Est Créteil (Upec), 94010 Créteil, France
| | - Laetitia Saccentia
- Department of Radiology, CHU Henri-Mondor, Assistance publique – hôpitaux de Paris (AP-HP), 1, rue Gustave-Eiffel, 94010 Créteil, France
- Université Paris-Est Créteil (Upec), 94010 Créteil, France
| | - Benjamin Longère
- Department of Radiology, CHU Henri-Mondor, Assistance publique – hôpitaux de Paris (AP-HP), 1, rue Gustave-Eiffel, 94010 Créteil, France
- Department of Cardiovascular Radiology, Institut Cœur-Poumon, CHU de Lille, 59037 Lille, France
| | - Maxime Blain
- Department of Radiology, CHU Henri-Mondor, Assistance publique – hôpitaux de Paris (AP-HP), 1, rue Gustave-Eiffel, 94010 Créteil, France
- Université Paris-Est Créteil (Upec), 94010 Créteil, France
| | - Giuliana Amaddeo
- Department of Hepatology, CHU Henri-Mondor, Assistance publique – hôpitaux de Paris (AP-HP), 94010 Créteil, France
| | - Alain Luciani
- Department of Radiology, CHU Henri-Mondor, Assistance publique – hôpitaux de Paris (AP-HP), 1, rue Gustave-Eiffel, 94010 Créteil, France
- Université Paris-Est Créteil (Upec), 94010 Créteil, France
- Unité Inserm U955, équipe n°18, IMRB, 94010 Créteil, France
| | - Hicham Kobeiter
- Department of Radiology, CHU Henri-Mondor, Assistance publique – hôpitaux de Paris (AP-HP), 1, rue Gustave-Eiffel, 94010 Créteil, France
- Université Paris-Est Créteil (Upec), 94010 Créteil, France
| | - Vania Tacher
- Department of Radiology, CHU Henri-Mondor, Assistance publique – hôpitaux de Paris (AP-HP), 1, rue Gustave-Eiffel, 94010 Créteil, France
- Université Paris-Est Créteil (Upec), 94010 Créteil, France
- Unité Inserm U955, équipe n°18, IMRB, 94010 Créteil, France
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Fu J, Lin G, Fang C, Chen B, Deng X, Chen J, Yang W, Huang Y, Qin A, Li X, Zeng C, Li X, Du L. Preparation, evaluation and application of MRI detectable sunitinib-loaded calcium alginate/poly(acrylic acid) hydrogel microspheres. Int J Biol Macromol 2024:131730. [PMID: 38688794 DOI: 10.1016/j.ijbiomac.2024.131730] [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: 12/05/2023] [Revised: 01/29/2024] [Accepted: 04/19/2024] [Indexed: 05/02/2024]
Abstract
Transcatheter arterial chemoembolization (TACE) is an effective method for the treatment of unresectable hepatocellular carcinoma. Although many embolic agents have been developed in TACE, there are few ideal embolic agents that combine drug loading, imaging properties and vessel embolization. Here, we developed novel magnetic embolic microspheres that could simultaneously load sunitinib malate (SU), be detected by magnetic resonance imaging (MRI) and block blood vessels. Calcium alginate/poly (acrylic acid) hydrogel microspheres (CA/PAA-MDMs) with superparamagnetic iron oxide nanoparticles (SPIONs) modified by citric acid were prepared by a drip and photopolymerization method. The embolization and imaging properties of CA/PAA-MDMs were evaluated through a series of experiments such as morphology, X-ray diffraction and X-ray photoelectron spectroscopy, magnetic responsiveness analysis, elasticity, cytotoxicity, hemolysis test, in vitro MRI evaluation, rabbit ear embolization and histopathology. In addition, the ability of drug loading and drug release of CA/PAA-MDMs were investigated by using sunitinib (SU) as the model drug. In conclusion, CA/PAA-MDMs showed outstanding drug loading capability, excellent imaging property and embolization effect, which would be expected to be used as a potential biodegradable embolic agent in the clinical interventional therapy.
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Affiliation(s)
- Jijun Fu
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, The NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences, The Second Affiliated Hospital and The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 511436, PR China; The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan, Guangdong 511436, PR China
| | - Guanli Lin
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, The NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences, The Second Affiliated Hospital and The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 511436, PR China
| | - Chenchen Fang
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, The NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences, The Second Affiliated Hospital and The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 511436, PR China
| | - Baiqi Chen
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, The NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences, The Second Affiliated Hospital and The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 511436, PR China
| | - Xingmei Deng
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, The NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences, The Second Affiliated Hospital and The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 511436, PR China
| | - Junhong Chen
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, The NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences, The Second Affiliated Hospital and The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 511436, PR China
| | - Weiqi Yang
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, The NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences, The Second Affiliated Hospital and The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 511436, PR China
| | - Yugang Huang
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, The NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences, The Second Affiliated Hospital and The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 511436, PR China; The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan, Guangdong 511436, PR China
| | - Aiping Qin
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, The NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences, The Second Affiliated Hospital and The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 511436, PR China
| | - Xufeng Li
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, The NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences, The Second Affiliated Hospital and The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 511436, PR China
| | - Caifang Zeng
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, The NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences, The Second Affiliated Hospital and The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 511436, PR China.
| | - Xin Li
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, The NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences, The Second Affiliated Hospital and The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 511436, PR China; The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan, Guangdong 511436, PR China.
| | - Lingran Du
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, The NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences, The Second Affiliated Hospital and The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 511436, PR China; The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan, Guangdong 511436, PR China.
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Chen J, Lai L, Zhou C, Luo J, Wang H, Li M, Huang M. Safety, efficacy, and survival of drug-eluting beads-transarterial chemoembolization vs. conventional-transarterial chemoembolization in advanced HCC patients with main portal vein tumor thrombus. Cancer Imaging 2023; 23:70. [PMID: 37481660 PMCID: PMC10362718 DOI: 10.1186/s40644-023-00581-8] [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: 11/24/2022] [Accepted: 06/01/2023] [Indexed: 07/24/2023] Open
Abstract
OBJECTIVES To compare the efficacy, overall survival (OS) and safety of drug-eluting beads-TACE (DEB-TACE) and C-TACE as initial treatment in advanced hepatocellular carcinoma (HCC) patients with main portal vein tumor thrombus (mPVTT). METHODS The medical records of consecutive advanced HCC patients with mPVTT who underwent initial DEB-TACE or C-TACE from September 2015 to October 2021 were retrospectively evaluated. Treatment crossover was allowed in this retrospective research. The adverse events, disease control rate (DCR), time to tumor progression (TTP) and OS of patients who underwent DEB-TACE were compared with those of patients who underwent C-TACE. RESULTS Eighty-three patients were included: 42 patients in DEB-TACE group and 41 patients in C-TACE group. DEB-TACE could be safely performed in HCC patients with mPVTT, and they gained a better DCR than those submitted to the C-TACE (76.2% vs. 53.7%, P = 0.031), which might have resulted in longer TTP (median TTP: 9.0 months vs. 3.0 months, P < 0.001). Furthermore, DEB-TACE showed significant OS benefits compared with C-TACE (median OS: 12.0 months vs. 5.0 months, P < 0.001). DEB-TACE, absence of arterioportal shunts (APS), leisons with capsular non-infiltration were found to be independent prognostic factors for better OS. Furthermore, subgroup analysis proved that patients with good DCR gained longer OS in DEB-TACE group. CONCLUSIONS DEB-TACE could be safely performed and improve the DCR of HCC patients with mPVTT, which resulting in longer TTP and OS, compared with C-TACE.
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Affiliation(s)
- Junwei Chen
- Department of Interventional Radiology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China
| | - Lisha Lai
- Department of Radiology, School of Medicine, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, 510180, China
| | - Churen Zhou
- Department of Interventional Radiology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China
| | - Junyang Luo
- Department of Interventional Radiology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China
| | - Haofan Wang
- Department of Interventional Radiology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China
| | - Mingan Li
- Department of Interventional Radiology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.
| | - Mingsheng Huang
- Department of Interventional Radiology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.
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Liu X, Wang X, Luo Y, Wang M, Chen Z, Han X, Zhou S, Wang J, Kong J, Yu H, Wang X, Tang X, Guo Q. A 3D Tumor-Mimicking In Vitro Drug Release Model of Locoregional Chemoembolization Using Deep Learning-Based Quantitative Analyses. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2206195. [PMID: 36793129 PMCID: PMC10104640 DOI: 10.1002/advs.202206195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/23/2022] [Indexed: 06/18/2023]
Abstract
Primary liver cancer, with the predominant form as hepatocellular carcinoma (HCC), remains a worldwide health problem due to its aggressive and lethal nature. Transarterial chemoembolization, the first-line treatment option of unresectable HCC that employs drug-loaded embolic agents to occlude tumor-feeding arteries and concomitantly delivers chemotherapeutic drugs into the tumor, is still under fierce debate in terms of the treatment parameters. The models that can produce in-depth knowledge of the overall intratumoral drug release behavior are lacking. This study engineers a 3D tumor-mimicking drug release model, which successfully overcomes the substantial limitations of conventional in vitro models through utilizing decellularized liver organ as a drug-testing platform that uniquely incorporates three key features, i.e., complex vasculature systems, drug-diffusible electronegative extracellular matrix, and controlled drug depletion. This drug release model combining with deep learning-based computational analyses for the first time permits quantitative evaluation of all important parameters associated with locoregional drug release, including endovascular embolization distribution, intravascular drug retention, and extravascular drug diffusion, and establishes long-term in vitro-in vivo correlations with in-human results up to 80 d. This model offers a versatile platform incorporating both tumor-specific drug diffusion and elimination settings for quantitative evaluation of spatiotemporal drug release kinetics within solid tumors.
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Affiliation(s)
- Xiaoya Liu
- Shenzhen Key Laboratory of Smart Healthcare EngineeringGuangdong Provincial Key Laboratory of Advanced BiomaterialsDepartment of Biomedical EngineeringSouthern University of Science and TechnologyShenzhenGuangdong518055P. R. China
- Department of PharmacyShenzhen Children's HospitalShenzhenGuangdong518026P. R. China
| | - Xueying Wang
- Department of Electronic and Electrical EngineeringSouthern University of Science and TechnologyShenzhenGuangdong518055P. R. China
| | - Yucheng Luo
- Shenzhen Key Laboratory of Smart Healthcare EngineeringGuangdong Provincial Key Laboratory of Advanced BiomaterialsDepartment of Biomedical EngineeringSouthern University of Science and TechnologyShenzhenGuangdong518055P. R. China
| | - Meijuan Wang
- Shenzhen Key Laboratory of Smart Healthcare EngineeringGuangdong Provincial Key Laboratory of Advanced BiomaterialsDepartment of Biomedical EngineeringSouthern University of Science and TechnologyShenzhenGuangdong518055P. R. China
| | - Zijian Chen
- Shenzhen Key Laboratory of Smart Healthcare EngineeringGuangdong Provincial Key Laboratory of Advanced BiomaterialsDepartment of Biomedical EngineeringSouthern University of Science and TechnologyShenzhenGuangdong518055P. R. China
| | - Xiaoyu Han
- Shenzhen Key Laboratory of Smart Healthcare EngineeringGuangdong Provincial Key Laboratory of Advanced BiomaterialsDepartment of Biomedical EngineeringSouthern University of Science and TechnologyShenzhenGuangdong518055P. R. China
| | - Sijia Zhou
- Department of MolecularCellular and Developmental Biology (MCD)Centre de Biologie Integrative (CBI)University of ToulouseCNRSUPSToulouse31062France
| | - Jiahao Wang
- Mechanobiology InstituteNational University of SingaporeSingapore117411Singapore
| | - Jian Kong
- Department of Interventional RadiologyFirst Affiliated Hospital of Southern University of Science and TechnologySecond Clinical Medical College of Jinan UniversityShenzhen People's HospitalShenzhenGuangdong518020P. R. China
| | - Hanry Yu
- Mechanobiology InstituteNational University of SingaporeSingapore117411Singapore
- Department of PhysiologyInstitute of Digital Medicineand Mechanobiology InstituteNational University of SingaporeSingapore117593Singapore
| | - Xiaobo Wang
- Department of MolecularCellular and Developmental Biology (MCD)Centre de Biologie Integrative (CBI)University of ToulouseCNRSUPSToulouse31062France
| | - Xiaoying Tang
- Department of Electronic and Electrical EngineeringSouthern University of Science and TechnologyShenzhenGuangdong518055P. R. China
- Jiaxing Research InstituteSouthern University of Science and TechnologyJiaxingZhejiang314000P. R. China
| | - Qiongyu Guo
- Shenzhen Key Laboratory of Smart Healthcare EngineeringGuangdong Provincial Key Laboratory of Advanced BiomaterialsDepartment of Biomedical EngineeringSouthern University of Science and TechnologyShenzhenGuangdong518055P. R. China
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Crovella S, Ouhtit A, Rahman SM, Rahman MM. Docosahexaenoic Acid, a Key Compound for Enhancing Sensitization to Drug in Doxorubicin-Resistant MCF-7 Cell Line. Nutrients 2023; 15:nu15071658. [PMID: 37049499 PMCID: PMC10097357 DOI: 10.3390/nu15071658] [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: 02/11/2023] [Revised: 03/26/2023] [Accepted: 03/27/2023] [Indexed: 04/14/2023] Open
Abstract
Drug resistance is a well-known and significant obstacle in the battle against cancer, rendering chemotherapy treatments often ineffective. To improve the effectiveness of chemotherapy, researchers are exploring the use of natural molecules that can enhance its ability to kill cancer cells and limit their spread. Docosahexaenoic acid (DHA), a lipid found in marine fish, has been shown to enhance the cytotoxicity of various anti-cancer drugs in vitro and in vivo. While the combined use of chemotherapeutic drugs with DHA demonstrated promising preliminary results in clinical trials, there is still a significant amount of information to be discovered regarding the precise mechanism of action of DHA. As the biological pathways involved in the chemosensitization of already chemoresistant MCF-7 cells are still not entirely unraveled, in this study, we aimed to investigate whether DHA co-treatment could enhance the ability of the chemotherapy drug doxorubicin to inhibit the growth and invasion of MCF-7 breast cancer cells (MCF-7/Dox) that had become resistant to the drug. Upon treating MCF-7/Dox cells with DHA or DHA-doxorubicin, it was observed that the DHA-doxorubicin combination effectively enhanced cancer cell death by impeding in vitro propagation and invasive ability. In addition, it led to an increase in doxorubicin accumulation and triggered apoptosis by arresting the cell cycle at the G2/M phase. Other observed effects included a decrease in the multi-drug resistance (MDR) carrier P-glycoprotein (P-gp) and TG2, a tumor survival factor. Augmented quantities of molecules promoting apoptosis such as Bak1 and caspase-3 and enhanced lipid peroxidation were also detected. Our findings in the cell model suggest that DHA can be further investigated as a natural compound to be used alongside doxorubicin in the treatment of breast cancer that is unresponsive to chemotherapy.
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Affiliation(s)
- Sergio Crovella
- Biological Sciences Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, Doha 2713, Qatar
| | - Allal Ouhtit
- Biological Sciences Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, Doha 2713, Qatar
| | - Shaikh Mizanoor Rahman
- Obesity and Cancer Biology Lab, Natural & Medical Sciences Research Center, University of Nizwa, Nizwa 616, Oman
| | - Md Mizanur Rahman
- Biological Sciences Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, Doha 2713, Qatar
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Zheng Z, Ma M, Han X, Li X, Huang J, Zhao Y, Liu H, Kang J, Kong X, Sun G, Sun G, Kong J, Tang W, Shao G, Xiong F, Song J. Idarubicin-loaded biodegradable microspheres enhance sensitivity to anti-PD1 immunotherapy in transcatheter arterial chemoembolization of hepatocellular carcinoma. Acta Biomater 2023; 157:337-351. [PMID: 36509402 DOI: 10.1016/j.actbio.2022.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 11/23/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022]
Abstract
Transarterial chemoembolization (TACE) is an image-guided locoregional therapy used for the treatment of patients with primary hepatocellular carcinoma (HCC). However, conventional TACE formulations such as epirubicin-lipiodol emulsion are rapidly dissociated due to the instability of the emulsion, resulting in insufficient local drug concentrations in the target tumor. To overcome these limitations, we used biodegradable Idarubicin loaded microspheres (BILMs), which were prepared from gelatin and carrageenan and could be loaded with Idarubicin (IDA-MS). The morphology and the ability to load and release IDA of BILMs were characterized in vitro. We evaluated tumor changes and side effects after TACE treatment with IDA-MS in VX2 rabbit and C57BL/6 mice HCC models. In addition, the effect of IDA-MS on the tumor immune microenvironment of HCC tumors was elucidated via mass spectrometry and immunohistochemistry. Result showed that IDA-MS was developed as a new TACE formulation to overcome the poor delivery of drugs due to rapid elimination of the anticancer drug into the systemic circulation. We demonstrated in rabbits and mice HCC models that TACE with IDA-MS resulted in significant tumor shrinkage and no more severe adverse events than those observed in the IDA group. TACE with IDA-MS could also significantly enhance the sensitivity of anti-PD1 immunotherapy, improve the expression of CD8+ T cells, and activate the tumor immune microenvironment in HCC. This study provides a new approach for TACE therapy and immunotherapy and illuminates the future of HCC treatment. STATEMENT OF SIGNIFICANCE: Conventional transarterial chemoembolization (TACE) formulations are rapidly dissociated due to the instability of the emulsion, resulting in insufficient local drug concentrations in hepatocellular carcinoma (HCC). To overcome these limitations, we used biodegradable microspheres called BILMs, which could be loaded with Idarubicin (IDA-MS). We demonstrated in rabbits and mice HCC models that TACE with IDA-MS resulted in significant tumor shrinkage and no more severe adverse events than those observed in the IDA group. TACE with IDA-MS could also significantly enhance the sensitivity of anti-PD1 immunotherapy, improve the expression of CD8+ T cells, and activate the tumor immune microenvironment in HCC. This study provides a new approach for TACE therapy and immunotherapy and illuminates the future of HCC treatment.
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Affiliation(s)
- Zhiying Zheng
- Hepatobiliary Center, Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, NHC Key Laboratory of Living Donor Liver Transplantation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China; Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Mingxi Ma
- State Key Laboratory of Bioelectronics, Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering & Collaborative Innovation Center of Suzhou Nano-Science and Technology, Southeast University, Nanjing, China
| | - Xiuping Han
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xiao Li
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jinxin Huang
- State Key Laboratory of Bioelectronics, Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering & Collaborative Innovation Center of Suzhou Nano-Science and Technology, Southeast University, Nanjing, China
| | - Yuetong Zhao
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Hanyuan Liu
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Junwei Kang
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiangyi Kong
- Hepatobiliary Center, Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, NHC Key Laboratory of Living Donor Liver Transplantation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Guoqiang Sun
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Guangshun Sun
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jie Kong
- Department of Intervention, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
| | - Weiwei Tang
- Hepatobiliary Center, Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, NHC Key Laboratory of Living Donor Liver Transplantation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Guoqiang Shao
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
| | - Fei Xiong
- State Key Laboratory of Bioelectronics, Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering & Collaborative Innovation Center of Suzhou Nano-Science and Technology, Southeast University, Nanjing, China.
| | - Jinhua Song
- Hepatobiliary Center, Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, NHC Key Laboratory of Living Donor Liver Transplantation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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Lv YF, Deng ZQ, Bi QC, Tang JJ, Chen H, Xie CS, Liang QR, Xu YH, Luo RG, Tang Q. Intratumoral Pi deprivation benefits chemoembolization therapy via increased accumulation of intracellular doxorubicin. Drug Deliv 2022; 29:1743-1753. [PMID: 35635315 PMCID: PMC9176673 DOI: 10.1080/10717544.2022.2081384] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
It is a decade-long controversy that transarterial chemoembolization (TACE) has definite priority over transarterial embolization (TAE) in treating patients with hepatocellular carcinoma (HCC), since HCC cells are regularly resistant to chemotherapy by enhanced expression of proteins that confer drug resistance, and ABC transporters pump the intracellular drug out of the cell. We addressed this issue by modulating the chemo-environment. In an animal model, sevelamer, a polymeric phosphate binder, was introduced as an embolic agent to induce intratumoral inorganic phosphate (Pi) starvation, and trans-arterially co-delivered with doxorubicin (DOX). The new type of TACE was named as DOX-TASE. This Pi-starved environment enhanced DOX tumoral accumulation and retention, and DOX-TASE thereby induced more severe tumor necrosis than that induced by conventional TACE (C-TACE) and drug-eluting bead TACE (D-TACE) at the same dose. In vitro tests showed that Pi starvation increased the cellular accumulation of DOX in an irreversible manner and enhanced cytotoxicity and cell apoptosis by suppressing the expression of ABC transporters (P-glycoprotein (P-gp), BCRP, and MRP1) and the production of intracellular ATP. Our results are indicative of an alternative interventional therapy combining chemotherapy with embolization more effectively.
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Affiliation(s)
- Yang-Feng Lv
- School of Public Health, Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China.,Institute for Advanced Study, Nanchang University, Nanchang, China
| | - Zhi-Qiang Deng
- Department of Oncology, The First People's Hospital of Fuzhou, Fuzhou, China
| | - Qiu-Chen Bi
- School of Public Health, Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China.,Institute for Advanced Study, Nanchang University, Nanchang, China
| | - Jian-Jun Tang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Hong Chen
- School of Public Health, Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China
| | - Chuan-Sheng Xie
- School of Public Health, Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China
| | - Qing-Rong Liang
- Institute for Advanced Study, Nanchang University, Nanchang, China
| | - Yu-Hua Xu
- Department of Interventional Radiology, Jiangxi Province Chest Hospital, Nanchang, China
| | - Rong-Guang Luo
- Department of Medical Imaging and Interventional Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qun Tang
- School of Public Health, Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China.,Institute for Advanced Study, Nanchang University, Nanchang, China.,Department of Oncology, The First People's Hospital of Fuzhou, Fuzhou, China
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8
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Doemel LA, Santana JG, Savic LJ, Gaupp FML, Borde T, Petukhova-Greenstein A, Kucukkaya AS, Schobert IT, Hamm CA, Gebauer B, Walsh JJ, Rexha I, Hyder F, Lin M, Madoff DC, Schlachter T, Chapiro J, Coman D. Comparison of metabolic and immunologic responses to transarterial chemoembolization with different chemoembolic regimens in a rabbit VX2 liver tumor model. Eur Radiol 2022; 32:2437-2447. [PMID: 34718844 PMCID: PMC9359419 DOI: 10.1007/s00330-021-08337-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 08/12/2021] [Accepted: 09/09/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES The goal of this study was to investigate the effects of TACE using Lipiodol, Oncozene™ drug-eluting embolics (DEEs), or LUMI™-DEEs alone, or combined with bicarbonate on the metabolic and immunological tumor microenvironment in a rabbit VX2 tumor model. METHODS VX2 liver tumor-bearing rabbits were assigned to five groups. MRI and extracellular pH (pHe) mapping using Biosensor Imaging of Redundant Deviation in Shifts (BIRDS) were performed before and after intra-arterial therapy with conventional TACE (cTACE), DEE-TACE with Idarubicin-eluting Oncozene™-DEEs, or Doxorubicin-eluting LUMI™-DEEs, each with or without prior bicarbonate infusion, and in untreated rabbits or treated with intra-arterial bicarbonate only. Imaging results were validated with immunohistochemistry (IHC) staining of cell viability (PCNA, TUNEL) and immune response (HLA-DR, CD3). Statistical analysis was performed using Mann-Whitney U test. RESULTS pHe mapping revealed that combining cTACE with prior bicarbonate infusion significantly increased tumor pHe compared to control (p = 0.0175) and cTACE alone (p = 0.0025). IHC staining revealed peritumoral accumulation of HLA-DR+ antigen-presenting cells and CD3 + T-lymphocytes in controls. cTACE-treated tumors showed reduced immune infiltration, which was restored through combination with bicarbonate. DEE-TACE with Oncozene™-DEEs induced moderate intratumoral and marked peritumoral infiltration, which was slightly reduced with bicarbonate. Addition of bicarbonate prior to LUMI™-beads enhanced peritumoral immune cell infiltration compared to LUMI™-beads alone and resulted in the strongest intratumoral immune cell infiltration across all treated groups. CONCLUSIONS The choice of chemoembolic regimen for TACE strongly affects post-treatment TME pHe and the ability of immune cells to accumulate and infiltrate the tumor tissue. KEY POINTS • Combining conventional transarterial chemotherapy with prior bicarbonate infusion increases the pHe towards a more physiological value (p = 0.0025). • Peritumoral infiltration and intratumoral accumulation patterns of antigen-presenting cells and T-lymphocytes after transarterial chemotherapy were dependent on the choice of the chemoembolic regimen. • Combination of intra-arterial treatment with Doxorubicin-eluting LUMI™-beads and bicarbonate infusion resulted in the strongest intratumoral presence of immune cells (positivity index of 0.47 for HLADR+-cells and 0.62 for CD3+-cells).
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Affiliation(s)
- Luzie A Doemel
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
- Department of Diagnostic and Interventional Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität, and Berlin Institute of Health, 10117, Berlin, Germany
| | - Jessica G Santana
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
| | - Lynn J Savic
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
- Department of Diagnostic and Interventional Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität, and Berlin Institute of Health, 10117, Berlin, Germany
- Berlin Institute of Health, 10178, Berlin, Germany
| | - Fabian M Laage Gaupp
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
| | - Tabea Borde
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, Technische Universitat München, Munich, Germany
| | - Alexandra Petukhova-Greenstein
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
- Department of Diagnostic and Interventional Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität, and Berlin Institute of Health, 10117, Berlin, Germany
| | - Ahmet S Kucukkaya
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
- Department of Diagnostic and Interventional Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität, and Berlin Institute of Health, 10117, Berlin, Germany
| | - Isabel T Schobert
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
- Department of Diagnostic and Interventional Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität, and Berlin Institute of Health, 10117, Berlin, Germany
| | - Charlie A Hamm
- Department of Diagnostic and Interventional Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität, and Berlin Institute of Health, 10117, Berlin, Germany
- Institute for Diagnostic Radiology and Neuroradiology, Greifswald University Hospital, Ferdinand-Sauerbruch-Strasse, 17475, Greifswald, Germany
| | - Bernhard Gebauer
- Department of Diagnostic and Interventional Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität, and Berlin Institute of Health, 10117, Berlin, Germany
| | - John J Walsh
- Department of Biomedical Engineering, School of Engineering & Applied Science, 17 Hillhouse Avenue, New Haven, CT, 06510, USA
| | - Irvin Rexha
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
- Department of Diagnostic and Interventional Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität, and Berlin Institute of Health, 10117, Berlin, Germany
| | - Fahmeed Hyder
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
- Department of Biomedical Engineering, School of Engineering & Applied Science, 17 Hillhouse Avenue, New Haven, CT, 06510, USA
- Yale Cancer Center, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
| | - MingDe Lin
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
- Visage Imaging, Inc., San Diego, CA, 92130, USA
| | - David C Madoff
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
- Yale Cancer Center, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
- Division of Medical Oncology, Department of Medicine, Yale School of Medicine, New Haven, CT, 06510, USA
- Yale Liver Center, Yale University School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
- Smilow Cancer Hospital Care Center - North Haven, 6 Devine Street, Fl 2, North Haven, CT, 06473, USA
| | - Todd Schlachter
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
| | - Julius Chapiro
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA.
- Yale Cancer Center, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA.
| | - Daniel Coman
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
- Yale Cancer Center, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
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9
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Cortes AC, Nishiofuku H, Polak U, Minhaj AA, Lopez MS, Kichikawa K, Qayyum A, Whitley EM, Avritscher R. Effect of bead size and doxorubicin loading on tumor cellular injury after transarterial embolization and chemoembolization in a rat model of hepatocellular carcinoma. NANOMEDICINE : NANOTECHNOLOGY, BIOLOGY, AND MEDICINE 2022; 39:102465. [PMID: 34571240 PMCID: PMC9206412 DOI: 10.1016/j.nano.2021.102465] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 05/08/2021] [Accepted: 09/01/2021] [Indexed: 01/03/2023]
Abstract
Embolic agents used in transarterial embolization for intermediate stage hepatocellular carcinoma reduce blood flow into tumors and can deliver anticancer drugs. Tumor blood supply can be interrupted using doxorubicin-eluting beads (DEB-TACE) or non-loaded beads (TAE) of different calibers. In this preclinical study, we characterized the extent of remaining stressed tumor cells after treatment, hypoxia within the surviving tumor regions, and inflammatory immune cell infiltrates after embolization with 40-60 or 70-150 μm with non-loaded or doxorubicin-loaded beads at 3 and 7 days after treatment. TAE-treated tumors had more stressed and surviving tumor cells after 3 days, irrespective of bead size, compared with DEB-TACE-treated tumors. Hypoxic stress of residual cells increased after treatment with 70-150 μm beads without or with doxorubicin. Treatment with DEB-TACE of 70-150 μm resulted in increased inflammation and proliferation in the adjacent parenchyma. Inflammatory cell infiltrates were reduced at the periphery of tumors treated with 40-60 μm DEB-TACE.
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Affiliation(s)
- Andrea C Cortes
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Hideyuki Nishiofuku
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX,Department of Radiology, IVR Center, Nara Medical University, Kashihara, Japan
| | - Urszula Polak
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Adeeb A Minhaj
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Mirtha S Lopez
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kimihiko Kichikawa
- Department of Radiology, IVR Center, Nara Medical University, Kashihara, Japan
| | - Aliya Qayyum
- Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Elizabeth M. Whitley
- Department of Veterinary Medicine and Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Rony Avritscher
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX,Corresponding author at: Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX. (R. Avritscher)
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10
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Li T, Shi Q, Liu J, Wang Y, Zhou C, Wang C, Ju S, Huang S, Yang C, Chen Y, Bai Y, Xiong B. Donafenib-Loaded Callispheres Beads Embolization in a VX2 Liver Tumor: Investigating Efficacy, Safety, and Improvement of Tumor Angiogenesis After Embolization. J Hepatocell Carcinoma 2021; 8:1525-1535. [PMID: 34888263 PMCID: PMC8651093 DOI: 10.2147/jhc.s337097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/20/2021] [Indexed: 11/24/2022] Open
Abstract
Objective To investigate the efficiency and safety of callispheres beads loaded with donafenib (DCBs) for embolization in a VX2 liver tumor, as well as the improvement of tumor angiogenesis following embolization. Methods Forty New Zealand white rabbit VX2 liver tumors were treated with four different drugs via the hepatic artery: NS (normal saline), CB (blank callispheres beads), ACB (adriamycin-loaded callispheres beads) and DCB (DCBs). Hematoxylin-eosin staining was performed to assess tumor necrosis, while MRI was employed to detect the changes in tumor size. The safety was evaluated by the liver and kidney function parameters, and the immunofluorescence and immunohistochemical staining were performed to reflect the tumor hypoxia and tumor angiogenesis following embolization. Results The DCB group had the smallest tumor growth rate, but the tumor necrosis rate was the highest of the four groups. Compared to the CB and ACB groups, the DCB group did not aggravate the liver damage and had no influence on kidney function. The staining results showed that, although the tumor hypoxia deteriorated after DCBs embolization, the expression of VEGF (vascular endothelial growth factor) reduced, thus inhibiting tumor angiogenesis. Conclusion DCB administration via hepatic artery is an effective and safe treatment for a preclinical liver cancer model, with the unique benefit of suppressing tumor angiogenesis following embolization.
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Affiliation(s)
- Tongqiang Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, People's Republic of China
| | - Qin Shi
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, People's Republic of China
| | - Jiacheng Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, People's Republic of China
| | - Yingliang Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, People's Republic of China
| | - Chen Zhou
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, People's Republic of China
| | - Chaoyang Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, People's Republic of China
| | - Shuguang Ju
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, People's Republic of China
| | - Songjiang Huang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, People's Republic of China
| | - Chongtu Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, People's Republic of China
| | - Yang Chen
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, People's Republic of China
| | - Yaowei Bai
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, People's Republic of China
| | - Bin Xiong
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, People's Republic of China
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11
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Gao X, Chen Z, Chen Z, Liu X, Luo Y, Xiao J, Gao Y, Ma Y, Liu C, Leo HL, Yu H, Guo Q. Visualization and Evaluation of Chemoembolization on a 3D Decellularized Organ Scaffold. ACS Biomater Sci Eng 2021; 7:5642-5653. [PMID: 34735119 DOI: 10.1021/acsbiomaterials.1c01005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Transarterial chemoembolization (TACE) has emerged as the mainstay treatment for patients suffering from unresectable intermediate hepatocellular carcinoma and also holds the potential to treat other types of hypervascular cancers such as renal cell carcinoma. However, an in vitro model for evaluating both embolic performance and drug-release kinetics of the TACE embolic agents is still lacking since the current models greatly simplified the in vivo vascular systems as well as the extracellular matrices (ECM) in the organs. Here, we developed a decellularized organ model with preserved ECM and vasculatures as well as a translucent appearance to investigate chemoembolization performances of a clinically widely used embolic agent, i.e., a doxorubicin-loaded ethiodised oil (EO)-based emulsion. We, for the first time, utilized an ex vivo model to evaluate the liquid-based embolic agent in two organs, i.e., liver and kidneys. We found that the EO-based emulsion with enhanced stability by incorporating an emulsifier, i.e., hydrogenated castor oil-40 (HCO), showed an enhanced occlusion level and presented sustained drug release in the ex vivo liver model, suggesting an advantageous therapeutic effect for TACE treatment of hepatocellular carcinoma. In contrast, we observed that drug-release burst happened when applying the same therapy in the kidney model even with the HCO emulsifier, which may be explained by the presence of the specific renal vasculature and calyceal systems, indicating an unfavorable effect in the renal tumor treatment. Such an ex vivo model presents a promising template for chemoembolization evaluation before in vivo experiments for the development of novel embolic agents.
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Affiliation(s)
- Xu Gao
- Shenzhen Key Laboratory of Smart Healthcare Engineering, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China
| | - Zijian Chen
- Shenzhen Key Laboratory of Smart Healthcare Engineering, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China.,Department of Biomedical Engineering, National University of Singapore, Engineering Drive 3, Engineering Block 4, #04-08, 117583 Singapore
| | - Zhengchang Chen
- Shenzhen Key Laboratory of Smart Healthcare Engineering, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China
| | - Xiaoya Liu
- Shenzhen Key Laboratory of Smart Healthcare Engineering, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China
| | - Yucheng Luo
- Shenzhen Key Laboratory of Smart Healthcare Engineering, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China
| | - Jingyu Xiao
- Shenzhen Key Laboratory of Smart Healthcare Engineering, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China
| | - Yanan Gao
- Shenzhen Key Laboratory of Smart Healthcare Engineering, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China
| | - Yutao Ma
- Shenzhen Key Laboratory of Smart Healthcare Engineering, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China
| | - Chuang Liu
- Cryo-EM Center, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China
| | - Hwa Liang Leo
- Department of Biomedical Engineering, National University of Singapore, Engineering Drive 3, Engineering Block 4, #04-08, 117583 Singapore
| | - Hanry Yu
- Mechanobiology Institute, National University of Singapore, 117411 Singapore.,Institute of Bioengineering and Nanotechnology, Agency for Science, Technology and Research, 138669 Singapore.,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, 117593 Singapore.,Singapore-MIT Alliance for Research and Technology, 138602 Singapore
| | - Qiongyu Guo
- Shenzhen Key Laboratory of Smart Healthcare Engineering, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China
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12
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Bucalau AM, Tancredi I, Verset G. In the Era of Systemic Therapy for Hepatocellular Carcinoma Is Transarterial Chemoembolization Still a Card to Play? Cancers (Basel) 2021; 13:5129. [PMID: 34680278 PMCID: PMC8533902 DOI: 10.3390/cancers13205129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/30/2021] [Accepted: 10/07/2021] [Indexed: 02/07/2023] Open
Abstract
Conventional transarterial embolization (cTACE) has been proven to be effective for intermediate stage hepatocellular carcinoma (HCC), with a recent systematic review showing an overall survival (OS) of 19.4 months. Nevertheless, due to the rapid development of the systemic therapeutic landscape, the place of TACE is becoming questionable. Is there still a niche for TACE in the era of immunotherapy and combination treatments such as atezolizumab-bevacizumab, which has shown an OS of 19.2 months with excellent tolerance? The development of drug-eluting microspheres (DEMs) has led to the standardization of the technique, and along with adequate selection, it showed an OS of 48 months in a retrospective study. In order to increase treatment selectivity, new catheters have also been added to the TACE arsenal as well as the use of cone-beam CT (CBCT), which provides three-dimensional volumetric images and guidance during procedures. Moreover, the TACE indications have also widened. It may serve as a "bridging therapy" for liver transplantation candidates while they are on the waiting list, and it represents a valuable downstaging tool to transplantation criteria. The aim of this review is to explore the current data on the advancements of TACE and its future place amongst the growing panel of treatments.
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Affiliation(s)
- Ana-Maria Bucalau
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Hôpital Erasme, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium;
| | - Illario Tancredi
- Department of Interventional Radiology, Hôpital Erasme, 1070 Brussels, Belgium;
| | - Gontran Verset
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Hôpital Erasme, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium;
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13
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Li L, Zhang Q, Li J, Tian Y, Kang Y, Ren G, Liu W, Wang H, Wang B, Yan L, Guo L, Diao H. Targeted Delivery of Doxorubicin Using Transferrin-Conjugated Carbon Dots for Cancer Therapy. ACS APPLIED BIO MATERIALS 2021; 4:7280-7289. [PMID: 35006957 DOI: 10.1021/acsabm.1c00811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A transferrin receptor (TfR)-targeted nanodrug [green fluorescence emission carbon dot (GCD)-polyethylene glycol (PEG)-transferrin (Tf)@doxorubicin (Dox)] for cancer therapy was developed by functionalizing GCDs with PEG, Tf, and Dox. GCDs were synthesized by the one-step hydrothermal method, followed by conjugating PEG and Tf by covalent bonds and loading Dox by electrostatic interactions. The nanodrug exhibits high stability under neutral conditions and effectively releases Dox at pH of 5.5. GCD-PEG-Tf@Dox can be selectively internalized by TfR-overexpressed tumor cells (MCF-7 and K150) via receptor-mediated endocytosis and further release Dox to the nuclei. As a result, GCD-PEG-Tf@Dox exhibits significant lethality to tumor cells (MCF-7 and K150) but greatly reduced toxicity to normal cells [Chinese hamster ovary cell line (CHO)] compared with free Dox. In vivo studies have confirmed that GCD-PEG-Tf@Dox can effectively inhibit tumor proliferation with negligible side effects.
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Affiliation(s)
- Lihong Li
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan 030001, PR China.,College of Basic Medical Sciences, Shanxi Medical University, Taiyuan 030001, PR China.,Key Laboratory of Cellular Physiology, Shanxi Medical University, Ministry of Education, Taiyuan 030001, PR China
| | - Qi Zhang
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan 030001, PR China
| | - Jinyao Li
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan 030001, PR China
| | - Yafei Tian
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan 030001, PR China
| | - Yu Kang
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan 030001, PR China
| | - Guodong Ren
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan 030001, PR China
| | - Wen Liu
- College of Basic Medical Sciences, Shanxi Medical University, Taiyuan 030001, PR China.,Key Laboratory of Cellular Physiology, Shanxi Medical University, Ministry of Education, Taiyuan 030001, PR China
| | - Haojiang Wang
- College of Basic Medical Sciences, Shanxi Medical University, Taiyuan 030001, PR China
| | - Bin Wang
- College of Basic Medical Sciences, Shanxi Medical University, Taiyuan 030001, PR China
| | - Lili Yan
- College of Basic Medical Sciences, Shanxi Medical University, Taiyuan 030001, PR China
| | - Lixia Guo
- College of Basic Medical Sciences, Shanxi Medical University, Taiyuan 030001, PR China
| | - Haipeng Diao
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan 030001, PR China.,College of Basic Medical Sciences, Shanxi Medical University, Taiyuan 030001, PR China.,Key Laboratory of Cellular Physiology, Shanxi Medical University, Ministry of Education, Taiyuan 030001, PR China
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14
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Zhang W, Lowerison MR, Dong Z, Miller RJ, Keller KA, Song P. Super-Resolution Ultrasound Localization Microscopy on a Rabbit Liver VX2 Tumor Model: An Initial Feasibility Study. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2416-2429. [PMID: 34045095 PMCID: PMC8278629 DOI: 10.1016/j.ultrasmedbio.2021.04.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 03/18/2021] [Accepted: 04/12/2021] [Indexed: 05/09/2023]
Abstract
Ultrasound localization microscopy can image microvasculature in vivo without sacrificing imaging penetration depth. However, the reliance on super-resolution inference limits the applicability of the technique because subpixel tissue motion can corrupt microvascular reconstruction. Consequently, the majority of previous pre-clinical research on this super-resolution procedure has been restricted to low-motion experimental models with ample motion correction or data rejection, which precludes the imaging of organ sites that exhibit a high degree of respiratory and other motion. In this article, we present a novel anesthesia protocol in rabbits that induces safe, controllable periods of apnea to enable the long image-acquisition times required for ultrasound localization microscopy. We apply this protocol to a VX2 liver tumor model undergoing sorafenib therapy and compare the results to super-resolution images from conventional high-dose isoflurane anesthesia. We find that the apneic protocol was necessary to correctly identify the poorly vascularized tumor cores, as verified by immunohistochemistry, and to reveal the tumoral microvascular architecture.
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Affiliation(s)
- Wei Zhang
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Wuhan, China
| | - Matthew R Lowerison
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Zhijie Dong
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Rita J Miller
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Krista A Keller
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Pengfei Song
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
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15
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Mikhail AS, Negussie AH, Mauda-Havakuk M, Owen JW, Pritchard WF, Lewis AL, Wood BJ. Drug-eluting embolic microspheres: State-of-the-art and emerging clinical applications. Expert Opin Drug Deliv 2021; 18:383-398. [PMID: 33480306 PMCID: PMC11247414 DOI: 10.1080/17425247.2021.1835858] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 10/07/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Drug-eluting embolic (DEE) microspheres, or drug-eluting beads (DEB), delivered by transarterial chemoembolization (TACE) serve as a therapeutic embolic to stop blood flow to tumors and a drug delivery vehicle. New combinations of drugs and DEE microspheres may exploit the potential synergy between mechanisms of drug activity and local tissue responses generated by TACE to enhance the efficacy of this mainstay therapy. AREAS COVERED This review provides an overview of key drug delivery concepts related to DEE microspheres with a focus on recent technological developments and promising emerging clinical applications as well as speculation into the future. EXPERT OPINION TACE has been performed for nearly four decades by injecting chemotherapy drugs into the arterial supply of tumors while simultaneously cutting off their blood supply, trying to starve and kill cancer cells, with varying degrees of success. The practice has evolved over the decades but has yet to fulfill the promise of truly personalized therapies envisioned through rational selection of drugs and real-time multi-parametric image guidance to target tumor clonality or heterogeneity. Recent technologic and pharmacologic developments have opened the door for potentially groundbreaking advances in how TACE with DEE microspheres is performed with the goal of achieving advancements that benefit patients.
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Affiliation(s)
- Andrew S Mikhail
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Ayele H Negussie
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Michal Mauda-Havakuk
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Joshua W Owen
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - William F Pritchard
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Andrew L Lewis
- Interventional Medicine Innovation Group, Biocompatibles UK, Ltd. (Now Boston Scientific Corp.), Camberley, UK
| | - Bradford J Wood
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
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16
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Kim D, Lee JH, Moon H, Seo M, Han H, Yoo H, Seo H, Lee J, Hong S, Kim P, Lee HJ, Chung JW, Kim H. Development and evaluation of an ultrasound-triggered microbubble combined transarterial chemoembolization (TACE) formulation on rabbit VX2 liver cancer model. Am J Cancer Res 2021; 11:79-92. [PMID: 33391462 PMCID: PMC7681087 DOI: 10.7150/thno.45348] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 09/17/2020] [Indexed: 02/06/2023] Open
Abstract
Transarterial chemoembolization (TACE) is an image-guided locoregional therapy used for the treatment of patients with primary or secondary liver cancer. However, conventional TACE formulations are rapidly dissociated due to the instability of the emulsion, resulting in insufficient local drug concentrations in the target tumor. Methods: To overcome these limitations, a doxorubicin-loaded albumin nanoparticle-conjugated microbubble complex in an iodized oil emulsion (DOX-NPs-MB complex in Lipiodol) has been developed as a new ultrasound-triggered TACE formulation. Results: (1) Microbubbles enhanced therapeutic efficacy by effectively delivering doxorubicin- loaded nanoparticles into liver tumors via sonoporation under ultrasound irradiation (US+). (2) Microbubbles constituting the complex retained their function as an ultrasound contrast agent in Lipiodol. In a rabbit VX2 liver cancer model, the in vivo study of DOX-NPs-MB complex in Lipiodol (US+) decreased the viability of tumor more than the conventional TACE formulation, and in particular, effectively killed cancer cells in the tumor periphery. Conclusion: Incorporation of doxorubicin-loaded microbubble in the TACE formulation facilitated drug delivery to the tumor with real-time monitoring and enhanced the therapeutic efficacy of TACE. Thus, the enhanced TACE formulation may represent a new treatment strategy against liver cancer.
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17
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Hulin A, Stocco J, Bouattour M. Clinical Pharmacokinetics and Pharmacodynamics of Transarterial Chemoembolization and Targeted Therapies in Hepatocellular Carcinoma. Clin Pharmacokinet 2020; 58:983-1014. [PMID: 31093928 DOI: 10.1007/s40262-019-00740-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The management of hepatocellular carcinoma (HCC) is based on a multidisciplinary decision tree. Treatment includes loco-regional therapy, mainly transarterial chemoembolization, for intermediate-stage HCC and systemic therapy with oral tyrosine kinase inhibitors (TKIs) for advanced HCC. Transarterial chemoembolization involves hepatic intra-arterial infusion with either conventional procedure or drug-eluting-beads. The aim of the loco-regional procedure is to deliver treatment as close as possible to the tumor both to embolize the tumor area and to enhance efficacy and minimize systemic toxicity of the anticancer drug. Pharmacokinetic studies applied to transarterial chemoembolization are rare and pharmacodynamic studies even rarer. However, all available studies lead to the same conclusions: use of the transarterial route lowers systemic exposure to the cytotoxic drug and leads to much higher tumor drug concentrations than does a similar dose via the intravenous route. However, reproducibility of the procedure remains a major problem, and no consensus exists regarding the choice of anticancer drug and its dosage. Systemic therapy with TKIs is based on sorafenib and lenvatinib as first-line treatment and regorafenib and cabozantinib as second-line treatment. Clinical use of TKIs is challenging because of their complex pharmacokinetics, with high liver metabolism yielding both active metabolites and their common toxicities. Changes in liver function over time with the progression of HCC adds further complexity to the use of TKIs. The challenges posed by TKIs and the HCC disease process means monitoring of TKIs is required to improve clinical management. To date, only partial data supporting sorafenib monitoring is available. Results from further pharmacokinetic/pharmacodynamic studies of these four TKIs are eagerly awaited and are expected to permit such monitoring and the development of consensus guidelines.
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Affiliation(s)
- Anne Hulin
- APHP, Laboratory of Pharmacology, GH Henri Mondor, EA7375, University Paris Est Creteil, 94010, Creteil, France
| | - Jeanick Stocco
- APHP, HUPNVS, Department of Clinical Pharmacy and Pharmacology, Beaujon University Hospital, 92110, Clichy, France
| | - Mohamed Bouattour
- APHP, HUPNVS, Department of Digestive Oncology, Beaujon University Hospital, 92110, Clichy, France.
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18
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Newell M, Patel D, Goruk S, Field CJ. Docosahexaenoic Acid Incorporation Is Not Affected by Doxorubicin Chemotherapy in either Whole Cell or Lipid Raft Phospholipids of Breast Cancer Cells in vitro and Tumor Phospholipids in vivo. Lipids 2020; 55:549-565. [PMID: 32588470 DOI: 10.1002/lipd.12252] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 11/07/2022]
Abstract
To better understand how docosahexaenoic acid (DHA) improves the effects of doxorubicin (DOX), we examined DHA ± DOX on changes in whole cell and lipid raft phospholipids (PL) of MDA-MB-231 and MCF-7 breast cancer cells. We sought to confirm whether the relative changes in PL DHA content of MDA-MB-231 cells could be extended to PL from MDA-MB-231 tumors grown in mice fed a DHA supplemented diet ±DOX. Treatment with DHA did not change PL composition yet DOX increased the proportion of phosphatidylserine in MCF-7 cell lipid rafts by two-fold (p < 0.001). Regardless of DOX, the relative percent incorporation of DHA was higher in MDA-MB-231 cells compared to MCF-7 cells in phosphatidylserine, phosphatidylethanolamine, and phosphatidylcholine (whole cell and lipid rafts); and higher in phosphatidylethanolamine vs. phosphatidylcholine (4.4-fold in MCF-7 and 6-fold in MDA-MB-231 cells respectively). DHA treatment increased eicosapentaenoic acid and docosapentaenoic acid in MDA-MB-231 cells but not MCF-7 cells. Increased DHA content in MDA-MB-231 cells, MCF-7 cells, and MDA-MB-231 tumors in all PL moieties (except sphingomyelin) corresponded with reduced arachidonic acid (p < 0.05). Feeding mice 2.8% (w/w of fat) DHA ± DOX increased tumor necrotic regions (p < 0.05). This study established differential incorporation of DHA into whole cell and lipid rafts between human breast cancer cell lines. However, within each cell line, this incorporation was not altered by DOX confirming that DOX does not change membrane lipid composition. Furthermore, our findings indicate that membrane changes observed in vitro are translatable to in vivo changes and that DHA + DOX could contribute to the anticancer effects through increased necrosis.
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Affiliation(s)
- Marnie Newell
- Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, AB, T6G 2E1, Canada
| | - Dhruvesh Patel
- Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, AB, T6G 2E1, Canada
| | - Susan Goruk
- Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, AB, T6G 2E1, Canada
| | - Catherine J Field
- Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, AB, T6G 2E1, Canada
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19
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Atanasov G, Dino K, Schierle K, Dietel C, Aust G, Pratschke J, Seehofer D, Schmelzle M, Hau HM. Recipient Hepatic Tumor-Associated Immunologic Infiltrates Predict Outcomes After Liver Transplantation for Hepatocellular Carcinoma. Ann Transplant 2020; 25:e919414. [PMID: 32165607 PMCID: PMC7092657 DOI: 10.12659/aot.919414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Transplantation of the liver entails a state of altered recipient immunologic competence. There are only scarce data concerning the impact of host immunologic factors on the outcome of liver transplant recipients in the context of hepatocellular carcinoma (HCC). Material/Methods Our study focused on evaluating the presence of tumor necrosis and frequency levels of angiopoietins and monocytes/macrophages subtypes in the host liver prior to liver transplantation (LTX) and their association with recurrence, graft rejection, survival, and clinical prognosis after LTX. Formation of tumor necrosis and tissue densities of angiopoietins and cellular immunologic infiltrates – CD68+ and CD163+ macrophages (TAMs) and TIE2-expressing monocytes (TEMs) – were quantified in recipient HCC specimens. The densities were then matched with clinicopathologic variables and patient survival after LTX (n=88). Some patients were treated prior to LTX by neoadjuvant transarterial chemoembolization (TACE, n=55). Results Recipient hepatic infiltration with TEMs and CD68+ TAMs was associated with decreased 1-, 3-, and 5-year survival, as well as metastatic and recurrent HCC after LTX (all p<0.05). TEMs and infiltrating monocytes/macrophages were associated with angiopoietin expression, metastatic, and recurrent HCC (all p<0.05). Furthermore, hepatic angiopoietin-2 expression was associated with graft rejection after LTX (p<0.05). After TACE and LTX, formation of tumor necrosis was associated with an increased presence of monocytes/macrophages and a reduced incidence of recurrent HCC in the graft (all p<0.05). Conclusions Infiltrating monocytes/macrophages subsets and related angiopoietin axis are associated with worse survival, tumor recurrence, and clinical outcome after LTX for HCC.
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Affiliation(s)
- Georgi Atanasov
- Department of Visceral-, Transplantation-, Thoracic- and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany.,Department of Surgery, Campus Charité Mitte und Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Karoline Dino
- Department of Visceral-, Transplantation-, Thoracic- and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Katrin Schierle
- Institute of Pathology, University Hospital Leipzig, Leipzig, Germany
| | - Corinna Dietel
- Department of Visceral-, Transplantation-, Thoracic- and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Gabriela Aust
- Department of Surgery, Research Laboratories, University of Leipzig, Leipzig, Germany
| | - Johann Pratschke
- Department of Surgery, Campus Charité Mitte und Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Daniel Seehofer
- Department of Visceral-, Transplantation-, Thoracic- and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Moritz Schmelzle
- Department of Visceral-, Transplantation-, Thoracic- and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany.,Department of Surgery, Campus Charité Mitte und Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Hans-Michael Hau
- Department of Visceral-, Transplantation-, Thoracic- and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
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20
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Luo J, Zheng J, Shi C, Fang J, Peng Z, Huang J, Sun J, Zhou G, Li T, Zhu D, Xu H, Hou Q, Ying S, Sun Z, Du H, Xie X, Cao G, Ji W, Han J, Gu W, Guo X, Shao G, Yu Z, Zhou J, Yu W, Zhang X, Li L, Hu H, Hu T, Wu X, Chen Y, Ji J, Hu W. Drug-eluting beads transarterial chemoembolization by CalliSpheres is effective and well tolerated in treating intrahepatic cholangiocarcinoma patients: A preliminary result from CTILC study. Medicine (Baltimore) 2020; 99:e19276. [PMID: 32195932 PMCID: PMC7220404 DOI: 10.1097/md.0000000000019276] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
This study aimed to investigate the efficacy and safety of drug-eluting beads (DEB) transarterial chemoembolization (TACE) treatment in Chinese intrahepatic cholangiocarcinoma (ICC) patients.37 ICC patients underwent DEB-TACE treatment in CTILC study (registered on clinicaltrials.gov with registry No. NCT03317483) were included in this present study. Treatment response was assessed according to modified Response Evaluation Criteria in Solid Tumors (mRECIST). Overall survival (OS) was calculated from the time of DEB-TACE operation until the date of death from any causes. Liver function change and adverse events (AEs) were recorded during and after DEB-TACE operation.3 (8.1%) patients achieved complete response (CR) and 22 (59.5%) patients achieved partial response (PR), with objective response rate (ORR) of 67.6%. After DEB-TACE treatment, mean OS was 376 days (95%CI: 341-412 days). Multivariate logistic regression analysis revealed that Bilobar disease (P = .040, OR: 0.105, 95% CI: 0.012-0.898) and portal vein invasion (P = .038, OR: 0.104, 95% CI: 0.012-0.881) could independently predict less possibility of ORR. Patients with ALB abnormal, TP abnormal, ALT abnormal and AST abnormal were increased at 1-week post DEB-TACE treatment (P = .034, P = .001, P < .001, P = .006, respectively), while returned to the levels at baseline after 1 to 3 months (all P > .050). Besides, most of the AEs were mild including pain, fever, vomiting, and nausea in this study.DEB-TACE was effective and well tolerated in treating ICC patients, and bilobar disease as well as portal vein invasion were independently correlated with less probability of ORR achievement.
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Affiliation(s)
- Jun Luo
- Department of Intervention, Zhejiang Cancer Hospital, Hangzhou
| | - Jiaping Zheng
- Department of Intervention, Zhejiang Cancer Hospital, Hangzhou
| | - Changsheng Shi
- Department of Intervention, The Third Affiliated Hospital of Wenzhou Medical University, Ruian, China
| | - Jian Fang
- Department of Hepatobiliary Surgery, Quzhou People's Hospital, Quzhou
| | - Zhiyi Peng
- Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou
| | - Jing Huang
- Department of Hepatobiliary Surgery, Ningbo Medical Center, Lihuili Eastern Hospital, Ningbo
| | - Junhui Sun
- Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou
| | - Guanhui Zhou
- Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou
| | - Tiefeng Li
- Department of Radiology, Beilun District People's Hospital of Ningbo, Ningbo
| | - Dedong Zhu
- Department of Liver Oncology, Ningbo No.2 Hospital, Ningbo, China
| | - Huanhai Xu
- Division of Digestive Endoscopy, Yueqing City People's Hospital, Yueqing
| | - Qinming Hou
- Department of Radiology, Xixi Hospital of Hangzhou, Hangzhou 6th People's Hospital, Hangzhou
| | - Shihong Ying
- Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou
| | - Zhichao Sun
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou
| | - Haijun Du
- Department of Intervention, Dong Yang people's Hospital, Dongyang
| | - Xiaoxi Xie
- Interventional Center, Xinchang People's Hospital, Shaoxing
| | - Guohong Cao
- Department of Radiology, Shulan (Hangzhou) Hospital, Zhejiang University International Hospital, Hangzhou
| | - Wenbin Ji
- Department of Radiology, Taizhou Hospital of Zhejiang Province, Linhai
| | - Jun Han
- Department of Intervention, Jiaxing First Hospital, Jiaxing
| | - Wenjiang Gu
- Department of Intervention, Jiaxing Second Hospital, Jiaxing
| | - Xiaohua Guo
- Department of Intervention, Jinhua Central Hospital, Jinhua
| | - Guoliang Shao
- Department of Intervention, Zhejiang Cancer Hospital, Hangzhou
| | - Zhihai Yu
- Department of Vascular and Interventional Radiology, The Affiliated Hospital of Medical College of Ningbo University, Ningbo
| | - Jian Zhou
- Department of Radiology, Hangzhou Cancer Hospital
| | - Wenqiang Yu
- Department of Intervention, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Xin Zhang
- Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou
| | - Ling Li
- Department of Liver Oncology, Ningbo No.2 Hospital, Ningbo, China
| | - Hongjie Hu
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou
| | - Tingyang Hu
- Department of Intervention, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Xia Wu
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou
| | - Yutang Chen
- Department of Intervention, Zhejiang Cancer Hospital, Hangzhou
| | - Jiansong Ji
- Department of Radiology, Lishui Central Hospital, Lishui Hospital of Zhejiang University, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui
| | - Wenhao Hu
- Department of Intervention, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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21
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Li X, Ji X, Chen K, Ullah MW, Yuan X, Lei Z, Cao J, Xiao J, Yang G. Development of finasteride/PHBV@polyvinyl alcohol/chitosan reservoir-type microspheres as a potential embolic agent: from in vitro evaluation to animal study. Biomater Sci 2020; 8:2797-2813. [PMID: 32080688 DOI: 10.1039/c9bm01775e] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Benign prostatic hyperplasia (BPH) is a prevalent urological disease affecting elders. Currently, the prostatic artery embolization (PAE) is considered as a minimally invasive and safe technique to treat BPH. However, various drug-loaded embolic agents have not been thoroughly investigated in BPH therapy. In this study, finasteride/poly(3-hydroxybutyrate-3-hydroxyvalerate)@polyvinyl alcohol/chitosan (FNS/PHBV@PVA/CS) reservoir-type microspheres were prepared via the solid-in-water-in-oil (S/W/O) emulsion crosslinking method with the aim to reduce the burst effect and control localized drug delivery. The structure and properties of the drug and resultant microspheres were characterized via field emission scanning electron microscopy (FESEM), Fourier-transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), and thermogravimetric analysis (TGA). The results showed that the drug-loaded hybrid microspheres were well-dispersed and spherical with a mean diameter of 238.1 ± 27.3 μm. All samples exhibited excellent thermal stability. The FNS/PHBV microspheres were successfully encapsulated inside the PVA/CS polymeric matrix, which effectively suppressed the burst effect and prolonged the drug release up to 51 days. In vitro biocompatibility assessment indicated that the microspheres possessed excellent cytocompatibility and hemocompatibility. Furthermore, in vivo studies performed in the rabbit ear embolization model showed the formation of progressive ischemic necrosis after treatment for various periods. Histopathological studies revealed that the microspheres completely occluded the blood vessels with minimal foreign body response and formed the fibrotic area at the periphery of embolized arteries. Furthermore, the auricular vascular endothelial cells showed acute ultrastructural changes, associated with the ischemic necrosis induced by the embolization procedures. All these findings suggest that the FNS/PHBV@PVA/CS hybrid microspheres could be used as a promising drug delivery system for potential applications in BPH therapy.
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Affiliation(s)
- Xiaohong Li
- Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan 430074, China.
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22
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Avritscher R, Jo N, Polak U, Cortes AC, Nishiofuku H, Odisio BC, Takaki H, Tam AL, Melancon MP, Yevich S, Qayyum A, Kaseb A, Kichikawa K, Gupta S, Goldberg SN, Chang SH. Hepatic Arterial Bland Embolization Increases Th17 Cell Infiltration in a Syngeneic Rat Model of Hepatocellular Carcinoma. Cardiovasc Intervent Radiol 2020; 43:311-321. [PMID: 31591689 DOI: 10.1007/s00270-019-02343-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 08/20/2019] [Accepted: 09/17/2019] [Indexed: 02/03/2023]
Abstract
PURPOSE To determine the tumor immune cell landscape after transcatheter arterial bland embolization (TAE) in a clinically relevant rat hepatocellular carcinoma (HCC) model. MATERIALS AND METHODS Buffalo rats (n = 21) bearing syngeneic McArdle RH-7777 rat hepatoma cells implanted into the left hepatic lobe underwent TAE using 70-150 µm beads (n = 9) or hepatic artery saline infusion (n = 12). HCC nodules, peritumoral margin, adjacent non-cancerous liver, and splenic parenchyma were collected and disaggregated to generate single-cell suspensions for immunological characterization 14 d after treatment. Changes in tumor-infiltrating immune subsets including CD4 T cells (Th17 and Treg), CD8 cytotoxic T cells (IFNγ), and neutrophils were evaluated by multiparameter flow cytometry. Migration and colony formation assays were performed to examine the effect of IL-17, a signature cytokine of Th17 cells, on McArdle RH-7777 hepatoma cells under conditions simulating post-embolization environment (i.e., hypoxia and nutrient privation). Statistical significance was determined by the Student unpaired t test or one-way ANOVA. RESULTS TAE induces increased infiltration of Th17 cells in liver tumors when compared with controls 14 d after treatment (0.29 ± 0.01 vs. 0.19 ± 0.02; p = 0.02). A similar pattern was observed in the spleen (1.41 ± 0.13 vs. 0.57 ± 0.08; p < 0.001), indicating both local and systemic effect. No significant differences in the percentage of FoxP3 + Tregs, IFNγ-producing CD4 T cells, and CD8 T cells were observed between groups (p > 0.05). In vitro post-embolization assays demonstrated that IL-17 reduces McA-RH7777 cell migration at 24-48 h (p = 0.003 and p = 0.002, respectively). CONCLUSION Transcatheter hepatic arterial bland embolization induces local and systemic increased infiltration of Th17 cells and expression of their signature cytokine IL-17. In a simulated post-embolization environment, IL-17 significantly reduced McA-RH7777 cell migration.
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Affiliation(s)
- Rony Avritscher
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
| | - NaHyun Jo
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Urszula Polak
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Andrea C Cortes
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Hideyuki Nishiofuku
- Department of Radiology, IVR Center, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Japan
| | - Bruno C Odisio
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Haruyuki Takaki
- Department of Radiological Technology, Hyogo College of Medicine College Hospital, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Hyogo, Japan
| | - Alda L Tam
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Marites P Melancon
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Steven Yevich
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Aliya Qayyum
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Ahmed Kaseb
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Kimihiko Kichikawa
- Department of Radiology, IVR Center, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Japan
| | - Sanjay Gupta
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - S Nahum Goldberg
- Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA.,Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Seon Hee Chang
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77054, USA
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23
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Keller S, Chapiro J, Brangsch J, Reimann C, Collettini F, Sack I, Savic LJ, Hamm B, Goldberg SN, Makowski M. Quantitative MRI for Assessment of Treatment Outcomes in a Rabbit VX2 Hepatic Tumor Model. J Magn Reson Imaging 2019; 52:668-685. [PMID: 31713973 DOI: 10.1002/jmri.26968] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/24/2019] [Accepted: 09/25/2019] [Indexed: 12/24/2022] Open
Abstract
Globally, primary and secondary liver cancer is one of the most common cancer types, accounting 8.2% of deaths worldwide in 2018. One of the key strategies to improve the patient's prognosis is the early diagnosis, when liver function is still preserved. In hepatocellular carcinoma (HCC), the typical wash-in/wash-out pattern in conventional magnetic resonance imaging (MRI) reaches a sensitivity of 60% and specificity of 96-100%. However, in recent years functional MRI sequences such as hepatocellular-specific gadolinium-based dynamic-contrast enhanced MRI, diffusion-weighted imaging (DWI), and magnetic resonance spectroscopy (MRS) have been demonstrated to improve the evaluation of treatment success and thus the therapeutic decision-making and the patient's outcome. In the preclinical research setting, the VX2 liver rabbit tumor, which once originated from a virus-induced anaplastic squamous cell carcinoma, has played a longstanding role in experimental interventional oncology. Especially the high tumor vascularity allows assessing the treatment response of locoregional interventions such as radiofrequency ablation (RFA) and transcatheter arterial embolization (TACE). Functional MRI has been used to monitor the tumor growth and viability following interventional treatment. Besides promising results, a comprehensive overview of functional MRI sequences used so far in different treatment setting is lacking, thus lowering the comparability of study results. This review offers a comprehensive overview of study protocols, results, and limitations of quantitative MRI sequences applied to evaluate the treatment outcome of VX2 hepatic tumor models, thus generating a unique basis for future MRI studies and potential translation into the clinical setting. Level of Evidence: 2 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2019. J. Magn. Reson. Imaging 2020;52:668-685.
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Affiliation(s)
- Sarah Keller
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Julius Chapiro
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Julia Brangsch
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Carolin Reimann
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Federico Collettini
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ingolf Sack
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Lynn Jeanette Savic
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Bernd Hamm
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Shraga Nahum Goldberg
- Department of Radiology, Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Marcus Makowski
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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24
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Duran R, Namur J, Pascale F, Czuczman P, Bascal Z, Kilpatrick H, Whomsley R, Ryan S, Lewis AL, Denys A. Vandetanib-eluting Radiopaque Beads: Pharmacokinetics, Safety, and Efficacy in a Rabbit Model of Liver Cancer. Radiology 2019; 293:695-703. [PMID: 31617791 DOI: 10.1148/radiol.2019190305] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Transarterial chemoembolization with cytotoxic drugs is standard treatment for unresectable intermediate-stage hepatocellular carcinoma but achieves suboptimal outcomes because of hypoxic stress and the production of detrimental proangiogenic factors. An alternative approach using radiopaque embolization beads loaded with the antiangiogenic drug vandetanib may provide improved anticancer efficacy. Purpose To evaluate the pharmacokinetics, safety, and efficacy of vandetanib-eluting radiopaque bead (VERB) chemoembolization of rabbit liver tumors. Materials and Methods Between April 2015 and March 2016, 60 New Zealand white rabbits with VX2 liver tumors were randomly treated with VERBs at different doses, with nonloaded radiopaque beads (ROBs), or with intra-arterial vandetanib suspension (VS) or were not treated. Vandetanib plasma concentration and tumor growth at US were evaluated. Animals were euthanized after 3 days or 3 weeks. Assessment included bead distribution at x-ray imaging and histologic examination, tumor viability at histologic examination, and vandetanib tissue concentration. Group comparison analysis (Mann-Whitney, Kruskal-Wallis, and χ2 tests) and predictive factor analysis for tumor growth and viability were performed. Results Vandetanib plasma concentration was lower with VERBs than with VS (P < .01), while concentration in tumor was higher for VERBs (than for VS) at 3 days (median, 29.2 vs 2.74 ng/mg; P = .48). Tumor growth was lower with VERBs than with ROBs and with VS at both time points, with median values of +114%, +192%, and +466% at 3 weeks, respectively. Tumor viability was lower at 3 days for VERBs than for ROBs and for VS (3%, 18%, and 38%, respectively) but was not significantly different at 3 weeks. The volume of bead in tumor was a significant predictive factor for lower tumor growth in multivariable analysis at 3 days (P = .03). Drug tumor concentration was a significant predictive factor for lower tumor growth at 3 weeks (P = .04). Conclusion Vandetanib-eluting radiopaque bead chemoembolization showed a pharmacokinetic advantage over intra-arterial drug administration in a preclinical model of liver cancer. High deposition of beads and high vandetanib concentration in tumor led to stronger antitumor effects. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Kim and Van den Abbeele in this issue.
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Affiliation(s)
- Rafael Duran
- From the Department of Radiology and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland (R.D., A.D.); Archimmed SARL, 12 rue Charles de Gaulle, Jouy-en-Josas 78350, France (J.N., F.P.); and Biocompatibles UK, a BTG International Group company, Camberley, England (P.C., Z.B., H.K., R.W., S.R., A.L.L.)
| | - Julien Namur
- From the Department of Radiology and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland (R.D., A.D.); Archimmed SARL, 12 rue Charles de Gaulle, Jouy-en-Josas 78350, France (J.N., F.P.); and Biocompatibles UK, a BTG International Group company, Camberley, England (P.C., Z.B., H.K., R.W., S.R., A.L.L.)
| | - Florentina Pascale
- From the Department of Radiology and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland (R.D., A.D.); Archimmed SARL, 12 rue Charles de Gaulle, Jouy-en-Josas 78350, France (J.N., F.P.); and Biocompatibles UK, a BTG International Group company, Camberley, England (P.C., Z.B., H.K., R.W., S.R., A.L.L.)
| | - Peter Czuczman
- From the Department of Radiology and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland (R.D., A.D.); Archimmed SARL, 12 rue Charles de Gaulle, Jouy-en-Josas 78350, France (J.N., F.P.); and Biocompatibles UK, a BTG International Group company, Camberley, England (P.C., Z.B., H.K., R.W., S.R., A.L.L.)
| | - Zainab Bascal
- From the Department of Radiology and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland (R.D., A.D.); Archimmed SARL, 12 rue Charles de Gaulle, Jouy-en-Josas 78350, France (J.N., F.P.); and Biocompatibles UK, a BTG International Group company, Camberley, England (P.C., Z.B., H.K., R.W., S.R., A.L.L.)
| | - Hugh Kilpatrick
- From the Department of Radiology and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland (R.D., A.D.); Archimmed SARL, 12 rue Charles de Gaulle, Jouy-en-Josas 78350, France (J.N., F.P.); and Biocompatibles UK, a BTG International Group company, Camberley, England (P.C., Z.B., H.K., R.W., S.R., A.L.L.)
| | - Rhys Whomsley
- From the Department of Radiology and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland (R.D., A.D.); Archimmed SARL, 12 rue Charles de Gaulle, Jouy-en-Josas 78350, France (J.N., F.P.); and Biocompatibles UK, a BTG International Group company, Camberley, England (P.C., Z.B., H.K., R.W., S.R., A.L.L.)
| | - Samantha Ryan
- From the Department of Radiology and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland (R.D., A.D.); Archimmed SARL, 12 rue Charles de Gaulle, Jouy-en-Josas 78350, France (J.N., F.P.); and Biocompatibles UK, a BTG International Group company, Camberley, England (P.C., Z.B., H.K., R.W., S.R., A.L.L.)
| | - Andrew L Lewis
- From the Department of Radiology and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland (R.D., A.D.); Archimmed SARL, 12 rue Charles de Gaulle, Jouy-en-Josas 78350, France (J.N., F.P.); and Biocompatibles UK, a BTG International Group company, Camberley, England (P.C., Z.B., H.K., R.W., S.R., A.L.L.)
| | - Alban Denys
- From the Department of Radiology and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland (R.D., A.D.); Archimmed SARL, 12 rue Charles de Gaulle, Jouy-en-Josas 78350, France (J.N., F.P.); and Biocompatibles UK, a BTG International Group company, Camberley, England (P.C., Z.B., H.K., R.W., S.R., A.L.L.)
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25
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Lee JH, Moon H, Han H, Lee IJ, Kim D, Lee HJ, Ha SW, Kim H, Chung JW. Antitumor Effects of Intra-Arterial Delivery of Albumin-Doxorubicin Nanoparticle Conjugated Microbubbles Combined with Ultrasound-Targeted Microbubble Activation on VX2 Rabbit Liver Tumors. Cancers (Basel) 2019; 11:cancers11040581. [PMID: 31022951 PMCID: PMC6521081 DOI: 10.3390/cancers11040581] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/20/2019] [Accepted: 04/22/2019] [Indexed: 12/19/2022] Open
Abstract
Image-guided intra-arterial therapies play a key role in the management of hepatic malignancies. However, limited clinical outcomes suggest the need for new multifunctional drug delivery systems to enhance local drug concentration while reducing systemic adverse reactions. Therefore, we developed the albumin-doxorubicin nanoparticle conjugated microbubble (ADMB) to enhance therapeutic efficiency by sonoporation under exposure to ultrasound. ADMB demonstrated a size distribution of 2.33 ± 1.34 µm and a doxorubicin loading efficiency of 82.7%. The echogenicity of ADMBs was sufficiently generated in the 2–9 MHz frequency range and cavitation depended on the strength of the irradiating ultrasound. In the VX2 rabbit tumor model, ADMB enhanced the therapeutic efficiency under ultrasound exposure, compared to free doxorubicin. The intra-arterial administration of ADMBs sufficiently reduced tumor growth by five times, compared to the control group. Changes in the ADC values and viable tumor fraction supported the fact that the antitumor effect of ADMBs were enhanced by evidence of necrosis ratio (over 70%) and survival tumor cell fraction (20%). Liver toxicity was comparable to that of conventional therapies. In conclusion, this study shows that tumor suppression can be sufficiently maximized by combining ultrasound exposure with intra-arterial ADMB administration.
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Affiliation(s)
- Jae Hwan Lee
- Department of Radiology, Seoul National University Bundang Hospital, 82 Gumi-ro 173, Bundang-gu, Seongnam 13620, Korea.
| | - Hyungwon Moon
- Department of Radiology, Seoul National University Bundang Hospital, 82 Gumi-ro 173, Bundang-gu, Seongnam 13620, Korea.
| | - Hyounkoo Han
- Department of Chemical & Biomolecular Engineering, Sogang University, 35 Baekbeom-ro, Mapo-gu, Seoul 04107, Korea.
| | - In Joon Lee
- Department of Radiology, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Korea.
| | - Doyeon Kim
- Department of Chemical & Biomolecular Engineering, Sogang University, 35 Baekbeom-ro, Mapo-gu, Seoul 04107, Korea.
| | - Hak Jong Lee
- Department of Radiology, Seoul National University Bundang Hospital, 82 Gumi-ro 173, Bundang-gu, Seongnam 13620, Korea.
- Department of Radiology, Seoul National University College of Medicine, Daehak-ro, Jongno-gu, Seoul 03080, Korea.
- IMGT Co., Ltd., 172 Dolma-ro, Bundang-gu, Seongnam 13605, Korea.
| | - Shin-Woo Ha
- IMGT Co., Ltd., 172 Dolma-ro, Bundang-gu, Seongnam 13605, Korea.
| | - Hyuncheol Kim
- Department of Chemical & Biomolecular Engineering, Sogang University, 35 Baekbeom-ro, Mapo-gu, Seoul 04107, Korea.
| | - Jin Wook Chung
- Department of Radiology, Seoul National University College of Medicine, Daehak-ro, Jongno-gu, Seoul 03080, Korea.
- Institute of Radiation Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul 03080, Korea.
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26
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Xiao YD, Ma C, Zhang ZS, Liu J. Safety and efficacy assessment of transarterial chemoembolization using drug-eluting beads in patients with hepatocellular carcinoma and arterioportal shunt: a single-center experience. Cancer Manag Res 2019; 11:1551-1557. [PMID: 30863165 PMCID: PMC6388950 DOI: 10.2147/cmar.s193948] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective To evaluate the feasibility and safety of transarterial chemoembolization with drug-eluting beads (DEB-TACE) in patients with hepatocellular carcinoma (HCC) and arterioportal shunts (APSs). Materials and methods Fifty-eight patients with unresectable HCC and APSs who were treated with DEB-TACE (n=26) or polyvinyl alcohol (PVA) plus TACE (PVA-TACE, n=32) were included in this retrospective study. The tumor response was evaluated by the modified Response Evaluation Criteria in Solid Tumors. Toxicity was graded by the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v5.0) and compared between the two groups. Survival curves were calculated by the Kaplan-Meier method and compared by the log-rank test between the two groups. The influence of potential prognostic factors on survival in the DEB-TACE group was analyzed via a multivariate Cox regression model. Results The disease control rate was better in the DEB-TACE group than in the PVA-TACE group. The median survival times were 346 and 274 days in the DEB-TACE group and PVA-TACE group, respectively. There was no significant difference in survival rates between the two groups (P=0.081). Patients treated with DEB-TACE were significantly less likely to have fever (P=0.048) or a low-grade (grade 1-2) increase in transaminases (P=0.046) than the patients treated with PVA-TACE. The potential predictive prognostic factors in the DEB-TACE group were tumor response, APS grading, and serum bilirubin. Conclusion DEB-TACE may be feasible and safe in HCC patients with APS. Survival in the DEB-TACE group was associated with tumor response, APS grading, and serum bilirubin levels.
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Affiliation(s)
- Yu-Dong Xiao
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha 410011, China, ;
| | - Cong Ma
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha 410011, China, ;
| | - Zi-Shu Zhang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha 410011, China, ;
| | - Jun Liu
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha 410011, China, ;
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27
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Chung JW, Kim HC. Can CT Following Chemoembolization with Radiopaque Drug-Eluting Beads Tell Us How Much Drug We Deliver? Radiology 2018; 289:405-406. [DOI: 10.1148/radiol.2018181275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Jin Wook Chung
- From the Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Hyo-Cheol Kim
- From the Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
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28
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Mikhail AS, Pritchard WF, Negussie AH, Krishnasamy VP, Amchin DB, Thompson JG, Wakim PG, Woods D, Bakhutashvili I, Esparza-Trujillo JA, Karanian JW, Willis SL, Lewis AL, Levy EB, Wood BJ. Mapping Drug Dose Distribution on CT Images Following Transarterial Chemoembolization with Radiopaque Drug-Eluting Beads in a Rabbit Tumor Model. Radiology 2018; 289:396-404. [PMID: 30106347 PMCID: PMC6219695 DOI: 10.1148/radiol.2018172571] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 05/30/2018] [Accepted: 06/14/2018] [Indexed: 12/15/2022]
Abstract
Purpose To correlate bead location and attenuation on CT images with the quantity and distribution of drug delivered to the liver following transarterial chemoembolization (TACE) with radiopaque drug-eluting beads (DEB) in a rabbit tumor model. Materials and Methods All procedures were performed with a protocol approved by the Institutional Animal Care and Use Committee. TACE was performed in rabbits (n = 4) bearing VX2 liver tumors by using radiopaque DEB (70-150 µm) loaded with doxorubicin (DOX). Livers were resected 1 hour after embolization, immediately frozen, and cut by using liver-specific three-dimensional-printed molds for colocalization of liver specimens and CT imaging. DOX penetration into tissue surrounding beads was evaluated with fluorescence microscopy. DOX levels in liver specimens were predicted by using statistical models correlating DOX content measured in tissue with bead volume and attenuation measured on CT images. Model predictions were then compared with actual measured DOX concentrations to assess the models' predictive power. Results Eluted DOX remained in close proximity (<600 µm) to beads in the liver 1 hour after TACE. Bead volume and attenuation measured on CT images demonstrated positive linear correlations (0.950 and 0.965, respectively) with DOX content in liver specimens. DOX content model predictions based on CT images were accurate compared with actual liver DOX levels at 1 hour. Conclusion CT may be used to estimate drug dose delivery and distribution in the liver following transarterial chemoembolization (TACE) with doxorubicin-loaded radiopaque drug-eluting beads (DEB). Although speculative, this informational map might be helpful in planning and understanding the spatial effects of TACE with DEB. © RSNA, 2018.
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Affiliation(s)
- Andrew S. Mikhail
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - William F. Pritchard
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Ayele H. Negussie
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Venkatesh P. Krishnasamy
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Daniel B. Amchin
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - John G. Thompson
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Paul G. Wakim
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - David Woods
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Ivane Bakhutashvili
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Juan A. Esparza-Trujillo
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - John W. Karanian
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Sean L. Willis
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Andrew L. Lewis
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Elliot B. Levy
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
| | - Bradford J. Wood
- From the Center for Interventional Oncology, Radiology and Imaging
Sciences, NIH Clinical Center (A.S.M., W.F.P., A.H.N., V.P.K., D.B.A., J.G.T.,
D.W., I.B., J.A.E.T., J.W.K., E.B.L., B.J.W.), National Institute of Biomedical
Imaging and Bioengineering (B.J.W.), National Cancer Institute Center for Cancer
Research (B.J.W.), and Biostatistics and Clinical Epidemiology Service, Clinical
Center (P.G.W.), National Institutes of Health, 10 Center Dr, Bethesda, MD
20892, and Biocompatibles UK, BTG International Group, Camberley, England
(S.L.W., A.L.L.)
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Monsky WL, Padia SA, Hardy AH. Dual-balloon infusion microcatheter for selective drug-eluting bead transarterial chemoembolization: initial feasibility study. Diagn Interv Radiol 2018; 23:454-460. [PMID: 29097347 DOI: 10.5152/dir.2017.17059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE We aimed to demonstrate feasibility of the use of a dual-balloon infusion microcatheter for segmental/subsegmental drug-eluting bead transarterial chemoembolization (DEB-TACE). METHODS Over a 16-month period, 15 segmental and 21 subsegmental DEB-TACE procedures were attempted using a dual-balloon anti-reflux microcatheter (IsoFlow™ microcatheter, Vascular Designs Inc.) in 21 patients (15 males; median age, 61 years; range, 49-82 years) with hepatocellular carcinoma (Barcelona clinic liver cancer stage A [n=4]; B [n=12]; C [n=5]) with one to three tumors, median size of 3.4 cm (1.2-9 cm). Follow-up enhanced computed tomography or magnetic resonance imaging was obtained at one month then subsequently every three months for one year. Technical success was evaluated. Modified RECIST criteria was used for target tumor response assessment. Safety was evaluated by assessing for arterial injury and hepatic injury at the time of the procedure and subsequent evidence of complications and liver toxicity. RESULTS In 26 of the procedures, the segmental/subsegmental arteries were thought not to be easily selected with standard microcatheters due to the arterial branches being severely tortuous/angulated or atretic from prior TACE or anti-angiogenic therapy or could not be catheterized. Radiologic response assessment of treated tumors demonstrated 32% complete response, 19% partial response, 34% stable disease, and 15% progressive disease. No complications occurred. The median time to progression for the targeted tumors was 7 months (range, 3-12 months). CONCLUSION DEB-TACE, using this dual-balloon anti-reflux infusion microcatheter is feasible and safe.
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Affiliation(s)
- Wayne L Monsky
- Division of Interventional Radiology, Department of Radiology, University of Washington Medical Center, Seattle, WA, USA.
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30
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Melancon MP, Appleton Figueira T, Fuentes DT, Tian L, Qiao Y, Gu J, Gagea M, Ensor JE, Muñoz NM, Maldonado KL, Dixon K, McWatters A, Mitchell J, McArthur M, Gupta S, Tam AL. Development of an Electroporation and Nanoparticle-based Therapeutic Platform for Bone Metastases. Radiology 2018; 286:149-157. [PMID: 28825892 DOI: 10.1148/radiol.2017161721] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Purpose To assess for nanopore formation in bone marrow cells after irreversible electroporation (IRE) and to evaluate the antitumoral effect of IRE, used alone or in combination with doxorubicin (DOX)-loaded superparamagnetic iron oxide (SPIO) nanoparticles (SPIO-DOX), in a VX2 rabbit tibial tumor model. Materials and Methods All experiments were approved by the institutional animal care and use committee. Five porcine vertebral bodies in one pig underwent intervention (IRE electrode placement without ablation [n = 1], nanoparticle injection only [n = 1], and nanoparticle injection followed by IRE [n = 3]). The animal was euthanized and the vertebrae were harvested and evaluated with scanning electron microscopy. Twelve rabbit VX2 tibial tumors were treated, three with IRE, three with SPIO-DOX, and six with SPIO-DOX plus IRE; five rabbit VX2 tibial tumors were untreated (control group). Dynamic T2*-weighted 4.7-T magnetic resonance (MR) images were obtained 9 days after inoculation and 2 hours and 5 days after treatment. Antitumor effect was expressed as the tumor growth ratio at T2*-weighted MR imaging and percentage necrosis at histologic examination. Mixed-effects linear models were used to analyze the data. Results Scanning electron microscopy demonstrated nanopores in bone marrow cells only after IRE (P , .01). Average volume of total tumor before treatment (503.1 mm3 ± 204.6) was not significantly different from those after treatment (P = .7). SPIO-DOX was identified as a reduction in signal intensity within the tumor on T2*-weighted images for up to 5 days after treatment and was related to the presence of iron. Average tumor growth ratios were 103.0% ± 75.8 with control treatment, 154.3% ± 79.7 with SPIO-DOX, 77% ± 30.8 with IRE, and -38.5% ± 24.8 with a combination of SPIO-DOX and IRE (P = .02). The percentage residual viable tumor in bone was significantly less for combination therapy compared with control (P = .02), SPIO-DOX (P , .001), and IRE (P = .03) treatment. The percentage residual viable tumor in soft tissue was significantly less with IRE (P = .005) and SPIO-DOX plus IRE (P = .005) than with SPIO-DOX. Conclusion IRE can induce nanopore formation in bone marrow cells. Tibial VX2 tumors treated with a combination of SPIO-DOX and IRE demonstrate enhanced antitumor effect as compared with individual treatments alone. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Marites P Melancon
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Tomas Appleton Figueira
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - David T Fuentes
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Li Tian
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Yang Qiao
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Jianhua Gu
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Mihai Gagea
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Joe E Ensor
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Nina M Muñoz
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Kiersten L Maldonado
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Katherine Dixon
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Amanda McWatters
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Jennifer Mitchell
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Mark McArthur
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Sanjay Gupta
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
| | - Alda L Tam
- From the Departments of Interventional Radiology (M.P.M., T.A.F., L.T., Y.Q., N.M.M., K.D., A.M., S.G., A.L.T.), Veterinary Medicine and Surgery (M.G., J.M., M.M.), and Imaging Physics (D.T.F., K.L.M.), the University of Texas M.D. Anderson Cancer Center, PO Box 301402, Unit 1471; Houston, TX 77230-1402; and Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, Tex (J.G., J.E.E.)
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Kennoki N, Hori S, Yuki T, Hori A. Transcatheter Arterial Chemoembolization with Spherical Embolic Agent in Patients with Pulmonary or Mediastinal Metastases from Breast Cancer. J Vasc Interv Radiol 2017; 28:1386-1394. [PMID: 28728935 DOI: 10.1016/j.jvir.2017.06.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 05/31/2017] [Accepted: 06/02/2017] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To evaluate safety and feasibility of transcatheter arterial chemoembolization with superabsorbent polymer microspheres (SAP-MS) for patients with pulmonary or mediastinal metastasis from breast cancer. METHODS Between November 2002 and January 2015, 14 patients with 29 unresectable pulmonary or mediastinal breast cancer metastases underwent transcatheter arterial chemoembolization using SAP-MS (50-100 μm) after injection of a combination of 2-4 types of anticancer drugs (eg, cisplatin [30 mg] + fluorouracil [500 mg], or epirubicin [40 mg] + mitomycin C [4 mg] + fluorouracil [500 mg]). As a primary endpoint, local tumor response and adverse events were evaluated 1 month after the first transcatheter arterial chemoembolization, according to Response Evaluation Criteria In Solid Tumors Version 1.1 and Common Terminology Criteria for Adverse Events Version 4 criteria. Transcatheter arterial chemoembolization was repeated as needed. Overall survival was analyzed as a secondary endpoint. RESULTS Response rate was 28.6% (partial response, 4 patients; stable disease, 10 patients). Median progression rate was -12.7%. No cases of hematologic toxicity of grade 3 or higher were observed. A grade 3 maculopapular rash was observed in 1 patient. After the first transcatheter arterial chemoembolization sessions, 63 additional transcatheter arterial chemoembolization sessions were performed (average, 5.5 sessions per patient; range, 2-10 sessions). The median overall survival time after the first session was 29 months, and the 5-year survival rate was 49.5%. CONCLUSIONS Transcatheter arterial chemoembolization with SAP-MS is a well-tolerated and feasible palliative treatment option for patients with pulmonary or mediastinal metastasis from breast cancer.
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Affiliation(s)
- Norifumi Kennoki
- Department of Radiology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachiouji-shi, Tokyo, Japan.
| | - Shinichi Hori
- Department of Radiology, IGT Clinic, Image Guided Therapy, Osaka, Japan
| | - Takeo Yuki
- Department of Radiology, Shiraniwa Hospital, Nara, Japan
| | - Atsushi Hori
- Department of Radiology, IGT Clinic, Image Guided Therapy, Osaka, Japan
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