Cryoablation for breast cancer: No need to turn a cold shoulder

Sabel, Michael S.

doi:10.1002/jso.20887

Cited by 11 publications

(6 citation statements)

References 16 publications

(11 reference statements)

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“…In comparison, the −20 °C isotherm for JT-based cryosystems is reported to penetrate < 6 mm and ~10 mm following 5 and 15 min of freezing, respectively [ 69 , 83 , 84 ]. Clinically, the position of the −20 °C and −40 °C isotherms are often important reference points [ 31 , 32 , 46 , 53 ]. With −20 °C to −25 °C reported as the minimal lethal temperature range for PDAC, we focused on the −20°C isotherm as a potential thermal target for PDAC ablation [ 68 , 70 , 71 ].…”

Section: Discussionmentioning

confidence: 99%

“…Additional reported benefits of cryoablation include enhanced depth of penetration, the ability to be used in conjunction with other treatments in an adjunctive role, improved hemostasis, and the ability to target unresectable tumors [ 46 , 47 , 48 ]. The delivery of cryoablative doses to tissues not conventionally targeted by cryoablation has expanded through the use of percutaneous needles or catheter-based approaches [ 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ]. However, for these therapies to achieve clinical viability, the cryotherapeutic approach must effectively deliver ablative temperatures in a confined, controlled, and time-efficient manner.…”

Section: Introductionmentioning

confidence: 99%

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The Assessment of a Novel Endoscopic Ultrasound-Compatible Cryocatheter to Ablate Pancreatic Cancer

Baust,

Robilotto,

Raijman

et al. 2024

Biomedicines

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Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal disease that may be treated utilizing thermal therapies. Cryoablation is an effective, minimally invasive therapy that has been utilized for the treatment of various cancers, offering patients a quicker recovery and reduced side effects. Cryoablation has been utilized on a limited basis for the treatment of PDAC. With the recent reports on the success of cryoablation, there is a growing interest in the use of cryoablation as a standalone, minimally invasive procedure to treat PDAC. While offering a promising path, the application of cryoablation to PDAC is limited by current technologies. As such, there is a need for the development of new devices to support advanced treatment strategies for PDAC. To this end, this study investigated the performance of a new endoscopic ultrasound-compatible cryoablation catheter technology, FrostBite. We hypothesized that FrostBite would enable the rapid, effective, minimally invasive delivery of ultra-cold temperatures to target tissues, resulting in effective ablation via an endoscopic approach. Thermal properties and ablative efficacy were evaluated using a heat-loaded gel model, tissue-engineered models (TEMs), and an initial in vivo porcine study. Freeze protocols evaluated included single and repeat 3 and 5 min applications. Isotherm assessment revealed the generation of a 2.2 cm diameter frozen mass with the −20 °C isotherm reaching a diameter of 1.5 cm following a single 5 min freeze. TEM studies revealed the achievement of temperatures ≤ −20 °C at a diameter of 1.9 cm after a 5 min freeze. Fluorescent imaging conducted 24 h post-thaw demonstrated a uniformly shaped ellipsoidal ablative zone with a midline diameter of 2.5 cm, resulting in a total ablative volume of 6.9 cm3 after a single 5 min freeze. In vivo findings consistently demonstrated the generation of ablative areas measuring 2.03 cm × 3.2 cm. These studies demonstrate the potential of the FrostBite cryocatheter as an endoscopic ultrasound-based treatment option. The data suggest that FrostBite may provide for the rapid, effective, controllable freezing of cancerous pancreatic and liver tissues. This ablative power also offers the potential of improved safety margins via the minimally invasive nature of an endoscopic ultrasound-based approach or natural orifice transluminal endoscopic surgery (NOTES)-based approach. The results of this pre-clinical feasibility study show promise, affirming the need for further investigation into the potential of the FrostBite cryocatheter as an advanced, minimally invasive cryoablative technology.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Assessment of a Novel Endoscopic Ultrasound-Compatible Cryocatheter to Ablate Pancreatic Cancer

Baust,

Robilotto,

Raijman

et al. 2024

Biomedicines

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“…This is compared to argon JT based cryosystems where the -20 • C isotherm is reported to penetrate <5 mm in 2 mins and ∼9 mm following 5+ mins of freezing [44,51,52]. Depth of penetration of the -20 • C and -40 • C isotherms are often used as reference points clinically [1,8,9,16,17,22,23]. With the reported minimal lethal temperature for BC in the range of -20 • C, we focused on the -20 • C isotherm as it represents a potential target isotherm for the treatment of BC [46].…”

Section: Discussionmentioning

confidence: 99%

“…Other benefits include depth of penetration, ability to use in combination with other treatments (adjunctive role), likely improved hemostasis and the ability to target non-resectable tumors [15][16][17][18]. Through percutaneous needles or catheter-based approaches, the delivery of cryoablative doses to tissues not traditionally targeted by the therapy have expanded [19][20][21][22][23][24][25][26][27][28][29]. Yet for such therapies to be clinically viable, the cryotherapeutic approach must be able to deliver ablative temperatures in a confined, controlled, and time efficient manner.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Novel Cystoscopic Compatible Cryocatheter for the Treatment of Bladder Cancer

Baust

Robilotto

Santucci

et al. 2020

BLC

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BACKGROUND: As the acceptance of cryoablative therapies for the treatment of non-metastatic cancers continues to grow, avenues for novel cryosurgical technologies and approaches have opened. Within the field of genitourinary tumors, cryosurgical treatments of bladder cancers remain largely investigational. Current modalities employ percutaneous needles or transurethral cryoballoons or sprays, and while results have been promising, each technology is limited to specific types and stages of cancers. OBJECTIVE: This study evaluated a new, self-contained transurethral cryocatheter, FrostBite-BC, for its potential to treat bladder cancer. METHODS: Thermal characteristics and ablative capacity were assessed using calorimetry, isothermal analyses, in vitro 3-dimensional tissue engineered models (TEMs), and a pilot in vivo porcine study. RESULTS: Isotherm assessment revealed surface temperatures below – 20°C within 9 sec. In vitro TEMs studies demonstrated attainment of ≤– 20°C at 6.1 mm and 8.2 mm in diameter following single and double 2 min freezes, respectively. Fluorescent imaging 24 hr post-thaw revealed uniform, ablative volumes of 326.2 mm3 and 397.9 mm3 following a single or double 2 min freeze. In vivo results demonstrated the consistent generation of ablative areas. Lesion depth was found to correlate with freeze time wherein 15 sec freezes resulted in ablation confined to the sub-mucosa and ≥30 sec full thickness ablation of the bladder wall. CONCLUSIONS: These studies demonstrate the potential of the FrostBite-BC cryocatheter as a treatment option for bladder cancer. Although preliminary, the outcomes of these studies were encouraging, and support the continued investigation into the potential of the FrostBite-BC cryocatheter as a next generation, minimally invasive cryoablative technology.

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“…Modern imaging techniques provide reliable histological diagnostic means for BC through tissue biopsy. And, minimally invasive treatments for BC, such as, radio frequency ablation, laser ablation, focal ultrasound ablation and cryotherapy, have developed rapidly in the past decades (Garbay et al 2008;Kontos et al 2008;Haraldsdóttir et al 2008;Wu et al 2007;Sabel 2008).…”

Section: Introductionmentioning

confidence: 99%

US-guided interstitial chemotherapy using paclitaxel temperature-responsive gel for breast cancer treatment in rat

Chen

Lin

Yang

et al. 2009

J Cancer Res Clin Oncol

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Cryoablation for breast cancer: No need to turn a cold shoulder

Cited by 11 publications

References 16 publications

The Assessment of a Novel Endoscopic Ultrasound-Compatible Cryocatheter to Ablate Pancreatic Cancer

The Assessment of a Novel Endoscopic Ultrasound-Compatible Cryocatheter to Ablate Pancreatic Cancer

Evaluation of a Novel Cystoscopic Compatible Cryocatheter for the Treatment of Bladder Cancer

US-guided interstitial chemotherapy using paclitaxel temperature-responsive gel for breast cancer treatment in rat

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