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Deipolyi AR, Ward RC, Riaz A, Vogl TJ, Simmons RM, Pieper CC, Bryce Y. Locoregional Therapies for Primary and Metastatic Breast Cancer: AJR Expert Panel Narrative Review. AJR Am J Roentgenol 2024; 222:e2329454. [PMID: 37377360 DOI: 10.2214/ajr.23.29454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Minimally invasive locoregional therapies have a growing role in the multidisciplinary treatment of primary and metastatic breast cancer. Factors contributing to the expanding role of ablation for primary breast cancer include earlier diagnosis, when tumors are small, and increased longevity of patients whose condition precludes surgery. Cryoablation has emerged as the leading ablative modality for primary breast cancer owing to its wide availability, the lack of need for sedation, and the ability to monitor the ablation zone. Emerging evidence suggests that in patients with oligometastatic breast cancer, use of locoregional therapies to eradicate all disease sites may confer a survival advantage. Evidence also suggests that transarterial therapies-including chemoembolization, chemoperfusion, and radioembolization-may be helpful to some patients with advanced liver metastases from breast cancer, such as those with hepatic oligoprogression or those who cannot tolerate systemic therapy. However, the optimal modalities for treatment of oligometastatic and advanced metastatic disease remain unknown. Finally, locoregional therapies may produce tumor antigens that in combination with immunotherapy drive anti-tumor immunity. Although key trials are ongoing, additional prospective studies are needed to establish the inclusion of interventional oncology in societal breast cancer guidelines to support further clinical adoption and improved patient outcomes.
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Affiliation(s)
- Amy R Deipolyi
- Department of Surgery, Interventional Radiology, West Virginia University/Charleston Area Medical Center, 3200 MacCorkle Ave SE, Charleston, WV 25304
| | - Robert C Ward
- Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Providence, RI
| | - Ahsun Riaz
- Department of Radiology, Northwestern Feinberg School of Medicine, Chicago, IL
| | - Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University Frankfurt, Frankfurt, Germany
| | - Rache M Simmons
- Department of Surgery, Weill Medical College of Cornell University, New York, NY
| | - Claus C Pieper
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Yolanda Bryce
- Division of Interventional Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
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Keyvani V, Mollazadeh S, Riahi E, Mahmoudian RA, Tabari M, Lagzian E, Ghorbani E, Akbarzade H, Gholami AS, Gataa IS, Hassanian SM, Ferns GA, Khazaei M, Avan A, Anvari K. The Application of Nanotechnological Therapeutic Platforms against Gynecological Cancers. Curr Pharm Des 2024; 30:975-987. [PMID: 38500284 DOI: 10.2174/0113816128291955240306112558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/20/2024] [Indexed: 03/20/2024]
Abstract
Gynecological cancers (GCs), ovarian, cervical, and endometrial/uterine cancers, are often associated with poor outcomes. Despite the development of several therapeutic modalities against GCs, the effectiveness of the current therapeutic approaches is limited due to their side effects, low therapeutic index, short halflife, and resistance to therapy. To overcome these limitations, nano delivery-based approaches have been introduced with the potential of targeted delivery, reduced toxicity, controlled release, and improved bioavailability of various cargos. This review summarizes the application of different nanoplatforms, such as lipid-based, metal- based, and polymeric nanoparticles, to improve the chemo/radio treatments of GC. In the following work, the use of nanoformulated agents to fight GCs has been mentioned in various clinical trials. Although nanosystems have their own challenges, the knowledge highlighted in this article could provide deep insight into translations of NPs approaches to overcome GCs.
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Affiliation(s)
- Vahideh Keyvani
- Department of Medical Genetics and Molecular Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Samaneh Mollazadeh
- Natural Products and Medicinal Plants Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Espanta Riahi
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Mashhad, Iran
- Department of Biology, Islamic Azad University, Mashhad Branch, Mashhad, Iran
| | - Reihaneh Alsadat Mahmoudian
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoomeh Tabari
- Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elmira Lagzian
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elnaz Ghorbani
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Akbarzade
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir-Sadra Gholami
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Seyed Mahdi Hassanian
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, Sussex BN1 9PH, UK
| | - Majid Khazaei
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Avan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane 4059, Australia
| | - Kazem Anvari
- Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Hegde YM, Theivendren P, Srinivas G, Palanivel M, Shanmugam N, Kunjiappan S, Vellaichamy S, Gopal M, Dharmalingam SR. A Recent Advancement in Nanotechnology Approaches for the Treatment of Cervical Cancer. Anticancer Agents Med Chem 2023; 23:37-59. [PMID: 35570521 DOI: 10.2174/1871520622666220513160706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/05/2022] [Accepted: 03/17/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Cervical cancer is one of the leading causes of female death, with a mortality rate of over 200,000 per year in developing countries. Despite a decrease in cervical cancer occurrences in developed countries over the last decade, the frequency of the disease in developing nations continues to rise at an alarming rate, particularly when it is linked to the human papillomavirus (HPV). With just a few highly invasive conventional therapies available, there is a clear need for novel treatment options such as nanotechnology-based chemotherapeutic drug delivery. METHODS Traditional anticancer therapy is limited by poor drug potency, non-specificity, unwanted side effects, and the development of multiple drug resistance (MDR), leading to a decrease in long-term anticancer therapeutic efficacy. An ideal cancer therapy requires a personalized and specialized medication delivery method capable of eradicating even the last cancer cell responsible for disease recurrence. RESULTS Nanotechnology provides effective drug delivery mechanisms, allowing it to serve both therapeutic and diagnostic purposes. Nanotechnology-based formulations are widely used to accurately target the target organ, maintain drug load bioactivity, preferentially accumulate the drug at the target location, and reduce cytotoxicity. CONCLUSION The key benefits of this drug delivery are that it improves pharmacological activity, solubility, and bioavailability and reduces toxicity in the target tissue by targeting ligands, allowing for new innovative treatment methods in an area that is desperately required. The goal of this review is to highlight possible research on nanotechnologybased delivery systems for cancer detection and treatment.
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Affiliation(s)
- Yashoda Mariappa Hegde
- Department of Pharmaceutics, Swamy Vivekananda College of Pharmacy, Elayampalayam, Namakkal, Tamilnadu 637205, India
| | - Panneerselvam Theivendren
- Department of Pharmaceutical Chemistry, Swamy Vivekananda College of Pharmacy, Elayampalayam, Namakkal, Tamilnadu 637205, India
| | - Geetha Srinivas
- Department of Pharmaceutics, Swamy Vivekananda College of Pharmacy, Elayampalayam, Namakkal, Tamilnadu 637205, India
| | - Monashilpa Palanivel
- Department of Pharmaceutics, Swamy Vivekananda College of Pharmacy, Elayampalayam, Namakkal, Tamilnadu 637205, India
| | - Nivetha Shanmugam
- Department of Pharmaceutics, Swamy Vivekananda College of Pharmacy, Elayampalayam, Namakkal, Tamilnadu 637205, India
| | - Selvaraj Kunjiappan
- Department of Biotechnology, Kalasalingam Academy of Research and Education, Krishnankoil-626126, India
| | - Sivakumar Vellaichamy
- Department of Pharmaceutics, Arulmigu Kalasalingam College of Pharmacy, Krishnankoil-626126, India
| | - Murugananthan Gopal
- Department of Pharmacognosy, Swamy Vivekananda College of Pharmacy, Elayampalayam, Namakkal, Tamilnadu 637205, India
| | - Senthil Rajan Dharmalingam
- Department of Pharmaceutics, Swamy Vivekananda College of Pharmacy, Elayampalayam, Namakkal, Tamilnadu 637205, India
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Wang N, Xu J, Wang G, Cao P, Ye X. Pancreatic intra-arterial infusion chemotherapy for the treatment of patients with advanced pancreatic carcinoma: A pilot study. J Cancer Res Ther 2022; 18:1945-1951. [PMID: 36647954 DOI: 10.4103/jcrt.jcrt_819_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Objective To preliminarily evaluate the efficacy and safety of pancreatic intra-arterial infusion chemotherapy (PAIC) with nab-paclitaxel in patients with advanced pancreatic carcinoma. Methods Fifteen patients with advanced pancreatic carcinoma received monthly, inpatient, 3-h, continuous PAIC of nab-paclitaxel at 180 mg/m2, combined with 60 mg oral tegafur gimeracil oteracil potassium capsule for 2 weeks. The therapeutic courses were repeated every 4 weeks. All patients had a preliminary diagnosis based on clinical symptoms, imaging data (computed tomography or magnetic resonance imaging or positron emission tomography/computed tomography), and tumor markers. The adverse effects, clinical benefit response (CBR), objective response rate (ORR), median progression free survival (mPFS), and median overall survival (mOS) were monitored. Results Fifteen patients with advanced pancreatic carcinoma were enrolled in this study, including 10 male and 5 female patients. The mean age at the time of treatment was 66.3 years (53-84 years). A total of 49 cycles of PAIC (mean = 3.27 cycles/patient) were performed. The most common treatment-related toxicities were alopecia, diarrhea, and nausea/vomiting. No procedure-related complications were observed. The longest overall survival observed was 22 months and the maximum number of treatments for the same patient was six cycles. PAIC contributed a high rate (13/15 [86.67%]) and fast (10/15 [66.67%]) easement of pain, with apparent symptom relief within 24 h, especially local pain symptom. The pain anesis rate was 13 (86.67%). CBR was achieved in 13 (86.67%) patients (95%CI [59.54,98.34]). ORR was achieved in four (26.67%) patients (95%CI [7.79,55.10]). Disease Control Rate was achieved in 14 (93.33%) patients. The mPFS was 5.22 months (interquartile range [IQR], 4.27-7.85 months). The mOS was 8.97 months (IQR, 5.65-13.70 months). Conclusions In this study, the dose of the chemotherapeutics and the schedule of the transcatheter pancreatic arterial chemotherapy perfusion were shown to be safe, well-tolerated, and effective for the relief of clinical symptoms and CBR. These advantages can quickly establish the treatment belief and improve patient quality of life. This regimen requires further investigation in patients with advanced pancreatic carcinoma.
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Affiliation(s)
- Nan Wang
- Department of Oncology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Lung Cancer Institute, Jinan, Shandong, China
| | - Jingwen Xu
- Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Jinan, Shandong, China
| | - Gang Wang
- Department of Oncology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Lung Cancer Institute, Jinan, Shandong, China
| | - Pikun Cao
- Department of Oncology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Lung Cancer Institute, Jinan, Shandong, China
| | - Xin Ye
- Department of Oncology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Lung Cancer Institute, Jinan, Shandong, China
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Intra-Arterial Therapies for Liver Metastatic Breast Cancer: A Systematic Review and Meta-Analysis. Cardiovasc Intervent Radiol 2021; 44:1868-1882. [PMID: 34322751 DOI: 10.1007/s00270-021-02906-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 06/15/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Performing a systematic review and meta-analysis to assess the evidence of intra-arterial therapies in liver metastatic breast cancer (LMBC) patients. METHODS A systemic literature search was performed in PubMed, EMBASE, SCOPUS for studies regarding intra-arterial therapies in LMBC patients. Full text studies of LMBC patients (n ≥ 10) published between January 2010 and December 2020 were included when at least one outcome among response rate, adverse events or survival was available. Response rates were pooled using generalized linear mixed models. A weighted estimate of the population median overall survival (OS) was obtained under the assumption of exponentially distributed survival times. RESULTS A total of 26 studies (1266 patients) were included. Eleven articles reported on transarterial radioembolization (TARE), ten on transarterial chemoembolization (TACE) and four on chemo-infusion. One retrospective study compared TARE and TACE. Pooled response rates were 49% for TARE (95%CI 32-67%), 34% for TACE (95%CI 22-50%) and 19% for chemo-infusion (95%CI 14-25%). Pooled median survival was 9.2 months (range 6.1-35.4 months) for TARE, 17.8 months (range 4.6-47.0) for TACE and 7.9 months (range 7.0-14.2) for chemo-infusion. No comparison for OS was possible due to missing survival rates at specific time points (1 and 2 year OS) and the large heterogeneity. CONCLUSION Although results have to be interpreted with caution due to the large heterogeneity, the superior response rate of TARE and TACE compared to chemo-infusion suggests first choice of TARE or TACE in chemorefractory LMBC patients. Chemo-infusion could be considered in LMBC patients not suitable for TARE or TACE. LEVEL OF EVIDENCE 3a.
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Li B, Chen X, Ding T, Liu Y, Ma T, Zhang G, Wang X. Nanoparticle albumin-bound paclitaxel versus solvent-based paclitaxel in breast cancer: A protocol for systemic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24514. [PMID: 33607781 PMCID: PMC7899816 DOI: 10.1097/md.0000000000024514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Nanoparticle albumin-bound paclitaxel (nab-PTX) has exhibited clinical efficacy in breast cancer treatment, but toxicities can be yielded more at the same time. We did this meta-analysis aiming to unambiguously compare nab-PTX with conventional solvent-based paclitaxel in breast cancer patients of all stages. METHOD Pubmed, EMBASE, Cochrane Library, Chinese Biomedical database, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical database, and WangFang database were searched for head-to-head randomized controlled trials of nab-PTX and solvent-based paclitaxel in breast cancer. Other sources will also be searched like Google Scholar and gray literatures. Two researchers will independently search the database and extract data from the articles. Risk of bias will be assessed using the Cochrane Collaboration's tool. Objective tumor response rate, chemotherapy completion rate after 4 or 6 cycles, and toxicity will be primary outcomes. Disease control rate, overall survival, and progression-free survival/disease-free survival will be included in secondary outcomes. Risk ratio with 95% confidence interval was used for dichotomous variables while hazard ratio was used for time-to-event outcomes. The following 3 data sets will all be considered when synthesizing the data: intention-to-treat population, those who actually received taxanes treatment, and those who were actually assessed. All the analyses were done using Review Manager Software 5.3. Any disagreements in study selection, data collection, and analysis will be resolved by a third investigator. RESULTS AND CONCLUSION This study is aim to evaluate the efficacy and safety of nab-PTX compared with PTX in breast cancer treatment as well as to find the best dose or schedule and identify the benefit population. This meta-analysis could provide evidence for clinicians to make a better choice between nab-PTX and PTX in different specific contexts. PROSPERO REGISTRATION NUMBER CRD42019117912.
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Affiliation(s)
- Bingxue Li
- Beijing University of Chinese Medicine, Chaoyang District
- Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Dongcheng District, Beijing, China
| | - Xinjie Chen
- Beijing University of Chinese Medicine, Chaoyang District
- Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Dongcheng District, Beijing, China
| | - Tongjing Ding
- Beijing University of Chinese Medicine, Chaoyang District
- Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Dongcheng District, Beijing, China
| | - Yihua Liu
- Beijing University of Chinese Medicine, Chaoyang District
| | - Tingting Ma
- Beijing University of Chinese Medicine, Chaoyang District
- Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Dongcheng District, Beijing, China
| | - Ganlin Zhang
- Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Dongcheng District, Beijing, China
| | - Xiaomin Wang
- Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Dongcheng District, Beijing, China
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Chi X, Liu K, Luo X, Yin Z, Lin H, Gao J. Recent advances of nanomedicines for liver cancer therapy. J Mater Chem B 2020; 8:3747-3771. [DOI: 10.1039/c9tb02871d] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This review highlights recent advancements in nanomedicines for liver cancer therapy.
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Affiliation(s)
- Xiaoqin Chi
- Fujian Provincial Key Laboratory of Chronic Liver Disease and Hepatocellular Carcinoma
- Zhongshan Hospital
- Xiamen University
- Xiamen 361004
- China
| | - Kun Liu
- The MOE Key Laboratory of Spectrochemical Analysis & Instrumentation
- The Key Laboratory for Chemical Biology of Fujian Province, and Department of Chemical Biology
- College of Chemistry and Chemical Engineering
- Xiamen University
- Xiamen 361005
| | - Xiangjie Luo
- The MOE Key Laboratory of Spectrochemical Analysis & Instrumentation
- The Key Laboratory for Chemical Biology of Fujian Province, and Department of Chemical Biology
- College of Chemistry and Chemical Engineering
- Xiamen University
- Xiamen 361005
| | - Zhenyu Yin
- Fujian Provincial Key Laboratory of Chronic Liver Disease and Hepatocellular Carcinoma
- Zhongshan Hospital
- Xiamen University
- Xiamen 361004
- China
| | - Hongyu Lin
- The MOE Key Laboratory of Spectrochemical Analysis & Instrumentation
- The Key Laboratory for Chemical Biology of Fujian Province, and Department of Chemical Biology
- College of Chemistry and Chemical Engineering
- Xiamen University
- Xiamen 361005
| | - Jinhao Gao
- The MOE Key Laboratory of Spectrochemical Analysis & Instrumentation
- The Key Laboratory for Chemical Biology of Fujian Province, and Department of Chemical Biology
- College of Chemistry and Chemical Engineering
- Xiamen University
- Xiamen 361005
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Phase I/II Study of Hepatic Arterial Infusion of Nab-paclitaxel in Patients With Metastatic Melanoma to the Liver. Am J Clin Oncol 2018; 41:1132-1136. [PMID: 29509591 DOI: 10.1097/coc.0000000000000436] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Hepatic arterial infusion (HAI) of cytotoxic chemotherapy is a strategy to deliver high dose of anticancer therapy to liver metastases that derive their blood supply from the hepatic artery. Metastatic melanoma (MM) has a high incidence of liver metastases, with uveal subtype in particular exhibiting a predilection for liver dissemination. Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) has demonstrated efficacy in MM and first-pass hepatic metabolism. Therefore, we hypothesized that HAI of nab-paclitaxel would deliver an effective dose of drug to the end organ of interest, with minimal systemic exposure. PATIENT AND METHODS We performed a single-institution open-label phase I/II study of HAI of nab-paclitaxel in MM patients with liver metastasis. Patients received treatment every 21 days at 4 different dose levels. The primary objective of the phase I portion of the study was safety and determination of the maximum-tolerated dose. The primary objective of the phase II portion of the study was overall response rate per Response Evaluation Criteria In Solid Tumors (RECIST) 1.0. RESULTS A total of 30 patients were treated between 2009 and 2013, 16 of whom had uveal melanoma. The maximum-tolerated dose was 220 mg/m and 19 patients were treated at this dose. There was 1 patient (5%) with a partial response at this dose, and 8 patients (42%) with stable disease at this dose. CONCLUSIONS HAI nab-paclitaxel demonstrates rare objective responses in melanoma patients with liver metastases. This treatment should be studied in combination with checkpoint blockade or other novel treatments to enhance meaningful responses but should not be considered effective monotherapy.
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Ranieri G, Marech I, Porcelli M, Giotta F, Palmiotti G, Laricchia G, Fazio V, Gadaleta CD. Complete response in a patient with liver metastases from breast cancer employing hepatic arterial infusion 5-fluorouracil based chemotherapy plus systemic nab-paclitaxel. Oncotarget 2017; 9:8197-8203. [PMID: 29487726 PMCID: PMC5814293 DOI: 10.18632/oncotarget.23793] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 12/11/2017] [Indexed: 11/25/2022] Open
Abstract
About half of patients with metastatic breast cancer (mBC) have unresectable liver metastases (LMs) or liver-predominant disease (LPD). Unfortunately systemic chemotherapy has limited tumor response due to LMs are supplied by hepatic artery. Hepatic intra-arterial (HAI) have antitumor activity in pretreated patients with LMs. Here we report the case of a 55-year-old woman affected by BCLPD and heavily pretreated. LMs responded to treatment based on HAI with 5-fluorouracil and nab-paclitaxel systemic chemotherapy, and they completely disappeared on a CT-scan. We conclude that this combination chemotherapy is safe and may be very useful for the treatment of patients with BCLPD. Therefore, this combination should be evaluated in a large study.
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Affiliation(s)
- Girolamo Ranieri
- Interventional and Medical Oncology Unit, National Cancer Research Center, Istituto Tumori Giovanni Paolo II, Viale Orazio Flacco, Bari, Italy
| | - Ilaria Marech
- Interventional and Medical Oncology Unit, National Cancer Research Center, Istituto Tumori Giovanni Paolo II, Viale Orazio Flacco, Bari, Italy
| | - Mariangela Porcelli
- Interventional and Medical Oncology Unit, National Cancer Research Center, Istituto Tumori Giovanni Paolo II, Viale Orazio Flacco, Bari, Italy
| | - Francesco Giotta
- Interventional and Medical Oncology Unit, National Cancer Research Center, Istituto Tumori Giovanni Paolo II, Viale Orazio Flacco, Bari, Italy
| | - Gennaro Palmiotti
- Interventional and Medical Oncology Unit, National Cancer Research Center, Istituto Tumori Giovanni Paolo II, Viale Orazio Flacco, Bari, Italy
| | - Giuseppe Laricchia
- Interventional and Medical Oncology Unit, National Cancer Research Center, Istituto Tumori Giovanni Paolo II, Viale Orazio Flacco, Bari, Italy
| | - Vito Fazio
- Interventional and Medical Oncology Unit, National Cancer Research Center, Istituto Tumori Giovanni Paolo II, Viale Orazio Flacco, Bari, Italy
| | - Cosmo Damiano Gadaleta
- Interventional and Medical Oncology Unit, National Cancer Research Center, Istituto Tumori Giovanni Paolo II, Viale Orazio Flacco, Bari, Italy
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Park JK, Utsumi T, Seo YE, Deng Y, Satoh A, Saltzman WM, Iwakiri Y. Cellular distribution of injected PLGA-nanoparticles in the liver. NANOMEDICINE : NANOTECHNOLOGY, BIOLOGY, AND MEDICINE 2016; 12:1365-74. [PMID: 26961463 PMCID: PMC4889500 DOI: 10.1016/j.nano.2016.01.013] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 01/12/2016] [Accepted: 01/21/2016] [Indexed: 12/27/2022]
Abstract
The cellular fate of nanoparticles in the liver is not fully understood. Because the effectiveness and safety of nanoparticles in liver therapy depends on targeting nanoparticles to the right cell populations, this study aimed to determine a relative distribution of PLGA-nanoparticles (sizes 271±1.4 nm) among liver cells in vivo. We found that Kupffer cells were the major cells that took up nanoparticles, followed by liver sinusoidal endothelial cells and hepatic stellate cells. Nanoparticles were found in only 7% of hepatocytes. Depletion of Kupffer cells by clodronate liposomes increased nanoparticle retention in liver sinusoidal endothelial cells and hepatic stellate cells, but not in hepatocytes. It is importantly suggested that studies of drug-loaded nanoparticle delivery to the liver have to demonstrate not only uptake of nanoparticles by the target cell type but also non-uptake by other cell types to assess their effect as well as ensure their safety.
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Affiliation(s)
- Jin-Kyu Park
- Section of Digestive Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA; Department of Veterinary Pathology, College of Veterinary Medicine, Kyungpook National University, Daegu, Republic of Korea.
| | - Teruo Utsumi
- Section of Digestive Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
| | - Young-Eun Seo
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA.
| | - Yang Deng
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA.
| | - Ayano Satoh
- The Graduate School of Natural Science and Technology, Okayama University, Okayama, Japan.
| | | | - Yasuko Iwakiri
- Section of Digestive Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
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Tanei T, Leonard F, Liu X, Alexander JF, Saito Y, Ferrari M, Godin B, Yokoi K. Redirecting Transport of Nanoparticle Albumin-Bound Paclitaxel to Macrophages Enhances Therapeutic Efficacy against Liver Metastases. Cancer Res 2016; 76:429-39. [PMID: 26744528 DOI: 10.1158/0008-5472.can-15-1576] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 10/21/2015] [Indexed: 11/16/2022]
Abstract
Current treatments for liver metastases arising from primary breast and lung cancers are minimally effective. One reason for this unfavorable outcome is that liver metastases are poorly vascularized, limiting the ability to deliver therapeutics from the systemic circulation to lesions. Seeking to enhance transport of agents into the tumor microenvironment, we designed a system in which nanoparticle albumin-bound paclitaxel (nAb-PTX) is loaded into a nanoporous solid multistage nanovector (MSV) to enable the passage of the drug through the tumor vessel wall and enhance its interaction with liver macrophages. MSV enablement increased nAb-PTX efficacy and survival in mouse models of breast and lung liver metastasis. MSV-nAb-PTX also augmented the accumulation of paclitaxel and MSV in the liver, specifically in macrophages, whereas paclitaxel levels in the blood were unchanged after administering MSV-nAb-PTX or nAb-PTX. In vitro studies demonstrated that macrophages treated with MSV-nAb-PTX remained viable and were able to internalize, retain, and release significantly higher quantities of paclitaxel compared with treatment with nAb-PTX. The cytotoxic potency of the released paclitaxel was also confirmed in tumor cells cultured with the supernatants of macrophage treated with MSV-nAB-PTX. Collectively, our findings showed how redirecting nAb-PTX to liver macrophages within the tumor microenvironment can elicit a greater therapeutic response in patients with metastatic liver cancer, without increasing systemic side effects.
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Affiliation(s)
- Tomonori Tanei
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas
| | - Fransisca Leonard
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas
| | - Xuewu Liu
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas
| | - Jenolyn F Alexander
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas
| | - Yuki Saito
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas
| | - Mauro Ferrari
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas
| | - Biana Godin
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas.
| | - Kenji Yokoi
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas.
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Siqing F, Culotta KS, Falchook GS, Hong DS, Myers AL, Zhang YP, Naing A, Janku F, Hou MM, Kurzrock R. Pharmacokinetic evaluation of nanoparticle albumin-bound paclitaxel delivered via hepatic arterial infusion in patients with predominantly hepatic metastases. Cancer Chemother Pharmacol 2015; 77:357-64. [DOI: 10.1007/s00280-015-2946-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Accepted: 12/11/2015] [Indexed: 11/29/2022]
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13
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Wang D, Fu Q, Tang J, Hackett M, Wang Y, Liu F. Molecular-matched materials for anticancer drug delivery and imaging. Nanomedicine (Lond) 2015; 10:3003-3013. [PMID: 26420013 DOI: 10.2217/nnm.15.117] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM In this study, we aim to construct nanoformulation with high-cargo loading and controlled serum kinetics. MATERIALS & METHODS Molecular-matched materials (MMMs) are established through the conjugation of the functional moiety to a molecule representative of the nanoparticle's core. Molecular-matched nanoemulsions and liposomes were prepared using MMMs. RESULTS This technique based on MMMs even allows us to efficiently load either hydrophobic or hydrophilic moieties into a hydrophobic core of the nanoparticles. MMMs-based nanoparticles showed marked improvement in serum pharmacokinetics and anticancer effect. CONCLUSION The desired performance can be achieved when the hydrophobic anchor of the PEG derivatives and the moiety conjugated to the therapeutic (or imaging) agents are molecularly identical to the core.
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Affiliation(s)
- Dun Wang
- Key Laboratory of Structure-Based Drug Design & Discovery, Ministry of Education, Shenyang Pharmaceutical University, Shenyang, 110016,China
| | - Qiang Fu
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Jingling Tang
- School of Pharmacy, Harbin Medical University, Harbin, 150081, China
| | - Michael Hackett
- Division of Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Yongjun Wang
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Feng Liu
- Division of Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Dose-finding study of hepatic arterial infusion of irinotecan-based treatment in patients with advanced cancers metastatic to the liver. Invest New Drugs 2015; 33:911-20. [PMID: 25990659 DOI: 10.1007/s10637-015-0251-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 05/10/2015] [Indexed: 01/21/2023]
Abstract
BACKGROUND Liver metastases are associated with a poor prognosis. We investigated the use of hepatic arterial infusion (HAI) of irinotecan combination therapy in patients with liver metastases. PATIENTS AND METHODS Patients with histologically confirmed advanced cancer with liver metastases that was refractory to standard therapy were eligible. A standard "3 + 3" phase I study design was used to determine the dose-limiting toxicity (DLT) and the maximum tolerated dose (MTD). Three cohorts were evaluated: HAI of irinotecan with systemic intravenous (IV) (a) bevacizumab, (b) oxaliplatin and bevacizumab, or (c) bevacizumab and cetuximab. RESULTS From October 2009 through December 2013, 98 patients with various tumor types were enrolled (median age, 62 years, range, 34-85; and median number of prior therapies, 4, range, 1-11). In cohorts A and C, dose escalation continued until the highest dose level-considered the MTD-was reached. In cohort B, dose escalation continued until dose level 3, and dose level 2 was considered the MTD. Rates of grade 3/4 adverse events were as follows: diarrhea, 8 %; fatigue, 4 %; neutropenia, 4 %; thrombocytopenia, 2 %; and skin rash, 2 %. Seventy-seven patients were evaluable for response. Partial response was noted in 5 (6.5 %) patients (neuroendocrine cancer, n = 2; CRC, n = 2; NSCLC, n = 1); and stable disease ≥ 6 months in 17 (22.1 %) patients (CRC, n = 13; breast, n = 1; neuroendocrine, n = 1; NSCLC, n = 1; pancreatic, n = 1). CONCLUSIONS HAI irinotecan in combination with bevacizumab; oxaliplatin plus bevacizumab; or cetuximab plus bevacizumab was safe and may be a treatment option for selected patients with advanced cancer and liver involvement.
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Chen J, Gu W, Yang L, Chen C, Shao R, Xu K, Xu ZP. Nanotechnology in the management of cervical cancer. Rev Med Virol 2015; 25:72-83. [DOI: 10.1002/rmv.1825] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Jiezhong Chen
- Australian Institute of Bioengineering and Nanotechnology; The University of Queensland; St Lucia QLD Australia
- School of Biomedical Sciences; The University of Queensland; St Lucia QLD Australia
| | - Wenyi Gu
- Australian Institute of Bioengineering and Nanotechnology; The University of Queensland; St Lucia QLD Australia
| | - Lei Yang
- School of Medicine and Health Management; Hangzhou Normal University; Hangzhou Zhejiang China
| | - Chen Chen
- School of Biomedical Sciences; The University of Queensland; St Lucia QLD Australia
| | - Renfu Shao
- GeneCology Research Centre, Faculty of Science, Health, Education and Engineering; The University of Sunshine Coast; Maroochydore QLD Australia
| | - Kewei Xu
- School of Medicine; The University of Queensland; St Lucia QLD Australia
| | - Zhi Ping Xu
- Australian Institute of Bioengineering and Nanotechnology; The University of Queensland; St Lucia QLD Australia
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Rychahou P, Haque F, Shu Y, Zaytseva Y, Weiss HL, Lee EY, Mustain W, Valentino J, Guo P, Evers BM. Delivery of RNA nanoparticles into colorectal cancer metastases following systemic administration. ACS NANO 2015; 9:1108-16. [PMID: 25652125 PMCID: PMC4613746 DOI: 10.1021/acsnano.5b00067] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The majority of deaths from all cancers, including colorectal cancer (CRC), is a result of tumor metastasis to distant organs. To date, an effective and safe system capable of exclusively targeting metastatic cancers that have spread to distant organs or lymph nodes does not exist. Here, we constructed multifunctional RNA nanoparticles, derived from the three-way junction (3WJ) of bacteriophage phi29 motor pRNA, to target metastatic cancer cells in a clinically relevant mouse model of CRC metastasis. The RNA nanoparticles demonstrated metastatic tumor homing without accumulation in normal organ tissues surrounding metastatic tumors. The RNA nanoparticles simultaneously targeted CRC cancer cells in major sites of metastasis, such as liver, lymph nodes, and lung. Our results demonstrate the therapeutic potential of these RNA nanoparticles as a delivery system for the treatment of CRC metastasis.
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Affiliation(s)
- Piotr Rychahou
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, United States
- Department of Surgery, University of Kentucky, Lexington, KY 40536, United States
| | - Farzin Haque
- Nanobiotechnology Center, University of Kentucky, Lexington, KY 40536, United States
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, KY 40536, United States
| | - Yi Shu
- Nanobiotechnology Center, University of Kentucky, Lexington, KY 40536, United States
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, KY 40536, United States
| | - Yekaterina Zaytseva
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, United States
| | - Heidi L. Weiss
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, United States
| | - Eun Y. Lee
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, United States
- Department of Surgery, University of Kentucky, Lexington, KY 40536, United States
- Pathology and Laboratory Medicine, University of Kentucky, Lexington, KY 40536, United States
| | - William Mustain
- Department of Surgery, University of Kentucky, Lexington, KY 40536, United States
| | - Joseph Valentino
- Department of Surgery, University of Kentucky, Lexington, KY 40536, United States
| | - Peixuan Guo
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, United States
- Nanobiotechnology Center, University of Kentucky, Lexington, KY 40536, United States
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, KY 40536, United States
| | - B. Mark Evers
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, United States
- Department of Surgery, University of Kentucky, Lexington, KY 40536, United States
- Corresponding Author: B. Mark Evers, M.D., Markey Cancer Center, University of Kentucky, 800 Rose Street, CC140, Lexington, KY 40536, Phone: 859-323-6556, Fax: 859-323-2074,
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Manji A, Brana I, Amir E, Tomlinson G, Tannock IF, Bedard PL, Oza A, Siu LL, Razak ARA. Evolution of clinical trial design in early drug development: systematic review of expansion cohort use in single-agent phase I cancer trials. J Clin Oncol 2013; 31:4260-7. [PMID: 24127441 DOI: 10.1200/jco.2012.47.4957] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate the use and objectives of expansion cohorts in phase I cancer trials and to explore trial characteristics associated with their use. METHODS We performed a systematic review of MEDLINE and EMBASE, limiting studies to single-agent phase I trials recruiting adults and published after 2006. Eligibility assessment and data extraction were performed by two reviewers. Data were assessed descriptively, and associations were tested by univariable and multivariable logistic regression. RESULTS We identified 611 unique phase I cancer trials, of which 149 (24%) included an expansion cohort. The trials were significantly more likely to use an expansion cohort if they were published more recently, were multicenter, or evaluated a noncytotoxic agent. Objectives of the expansion cohort were reported in 74% of trials. In these trials, safety (80%), efficacy (45%), pharmacokinetics (28%), pharmacodynamics (23%), and patient enrichment (14%) were cited as objectives. Among expansion cohorts with safety objectives, the recommended phase II dose was modified in 13% and new toxicities were described in 54% of trials. Among trials aimed at assessing efficacy, only 11% demonstrated antitumor activity assessed by response criteria that was not previously observed during dose escalation. CONCLUSION The utilization of expansion cohorts has increased with time. Safety and efficacy are common objectives, but 26% fail to report explicit aims. Expansion cohorts may provide useful supplementary data for phase I trials, particularly with regard to toxicity and definition of recommended dose for phase II studies.
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Affiliation(s)
- Arif Manji
- Arif Manji, Irene Brana, Eitan Amir, Ian F. Tannock, Philippe L. Bedard, Amit Oza, Lillian L. Siu, and Albiruni R. Abdul Razak, Princess Margaret Cancer Centre, University Health Network; George Tomlinson, University of Toronto; and Arif Manji, Hospital for Sick Children, Toronto, and Southlake Regional Health Centre, Newmarket, Ontario, Canada
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A phase I study of hepatic arterial infusion of nab-paclitaxel in combination with intravenous gemcitabine and bevacizumab for patients with advanced cancers and predominant liver metastases. Cancer Chemother Pharmacol 2013; 71:955-63. [PMID: 23377373 DOI: 10.1007/s00280-013-2088-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 01/12/2013] [Indexed: 12/29/2022]
Abstract
PURPOSE We conducted a phase I clinical trial for patients with advanced cancer and predominant liver disease. METHODS Patients were treated with HAI nab-paclitaxel (120-210 mg/m(2); day 1); intravenous bevacizumab (10 mg/kg; day 1); and intravenous gemcitabine (600-800 mg/m(2); days 1 and 8). A conventional "3 + 3" study design was used. RESULTS Fifty patients with advanced cancer and predominant liver metastases were treated (median age, 58 years; 27 women, 23 men; median number of prior therapies, 3 [range 0-12]). The most common cancers were breast (n = 9) and pancreatic (n = 9). Overall, 264 cycles were administered (median/patient, 4; range 1-17). No dose-limiting toxicities were noted during the escalation phase. On dose level 4, 3 patients were unable to receive gemcitabine on day 8 because of severe thrombocytopenia. Dose level 3 was selected as the maximum-tolerated dose (HAI nab-paclitaxel 180 mg/m(2) and intravenous gemcitabine 800 mg/m(2) and bevacizumab 10 mg/kg); 32 patients were treated in the expansion phase. The most common treatment-related toxicities were thrombocytopenia (n = 17), neutropenia (n = 10), and fatigue (n = 12). Of 46 patients evaluable for response, 9 (20 %) had a partial response (PR) and 9 (20 %) had stable disease for ≥6 months. The median overall survival duration was 7.0 months (95 % CI: 4, 22 months), and the median progression-free survival duration was 4.2 months (95 % CI: 2.7, 8.6 months). CONCLUSIONS HAI nab-paclitaxel in combination with gemcitabine and bevacizumab was well tolerated and had antitumor activity in selected patients with advanced cancer and liver metastases.
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