Direct injection of anti-cancer drugs into endobronchial tumours for palliation of major airway obstruction

Celikoglu, SI; Karayel, Tuncer; Demirci, Sabriye; Çelikoğlu, Firuz; Çağatay, Tülin

doi:10.1136/pgmj.73.857.159

Cited by 33 publications

(38 citation statements)

References 5 publications

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“…[18][19][20]. Clinical experiences showed that after the direct injection of cytotoxic drugs into the tumor through a bronchoscope, the size of the mass in the lumen of airway was significantly reduced and malignant infiltrations of mucous membrane improved, most likely due to very high concentrations of cytotoxic material around the tumor cells causing an immediate necrotic effect [18][19][20].…”

Section: Intratumoral Injection By Bronchoscopymentioning

confidence: 97%

“…Studies have shown that intratumoral injection of cytotoxic drugs into the tumor (intratumoral chemotherapy) has been successful in the debulking of airways [18][19][20]. The aim of the present work was therefore to study the effectiveness, safety, and feasibility of initial debulking by intratumoral chemotherapy with cisplatin followed by irradiation in the treatment of obstructive inoperable nonsmall cell lung cancer.…”

Section: Introductionmentioning

confidence: 98%

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Intratumoral administration of cisplatin through a bronchoscope followed by irradiation for treatment of inoperable non-small cell obstructive lung cancer

et al. 2006

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Section: Intratumoral Injection By Bronchoscopymentioning

confidence: 97%

Section: Introductionmentioning

confidence: 98%

Intratumoral administration of cisplatin through a bronchoscope followed by irradiation for treatment of inoperable non-small cell obstructive lung cancer

et al. 2006

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“…However ® ve of 17 patients showed no response (Firusian & Dempke 1999). An interesting and unusual application of intratumoral chemotherapy involved treatment of inoperable tracheal}airways tumours which severely obstructed breathing (Celikoglu et al 1997). The endobronchial tumours were treated via¯exible ® bre optic guided bronchoscope with multiple 1± 3 mL injections using a complex multi-drug regimen : 50 mg¯uorouracil, 1 mg mitomycin, 5 mg methotrexate, 10 mg bleomycin, 2 mg mitoxantrone.…”

Section: Human Intratumoral Chemotherapy Studies Drug± Gel Compositionsmentioning

confidence: 99%

Intratumoral cancer chemotherapy and immunotherapy: opportunities for nonsystemic preoperative drug delivery

Goldberg

Hadba

Almond

et al. 2002

Journal of Pharmacy and Pharmacology

175

143

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The recent literature documents the growing interest in local intratumoral chemotherapy as well as systemic preoperative chemotherapy with evidence for improved outcomes using these therapeutic modalities. Nevertheless, with few exceptions, the conventional wisdom and standard of care for clinical and surgical oncology remains surgery followed by radiation and/or systemic chemotherapy, as deemed appropriate based on clinical ndings. This, in spite of the fact that the toxicity of conventional systemic chemotherapy and immunotherapy affords limited effectiveness and frequently compromises the quality of life for patients. Indeed, with systemic chemotherapy, the oncologist (and the patient) often walks a ne line between attempting tumour remission with prolonged survival and damaging the patient's vital functions to the point of death. In this context, it has probably been obvious for more than 100 years, due in part to the pioneering work of Ehrlich (1878), that targeted or localized drug delivery should be a major goal of chemotherapy. However, there is still only limited clinical use of nonsystemic intratumoral chemotherapy for even those high mortality cancers which are characterized by well de ned primary lesions i.e. breast, colorectal, lung, prostate, and skin.There has been a proliferation of intratumoral chemotherapy and immunotherapy research during the past two to three years. It is therefore the objective of this review to focus much more attention upon intratumoral therapeutic concepts which could limit adverse systemic events and which might combine clinically feasible methods for localized preoperative chemotherapy and/or immunotherapy with surgery. Since our review of intratumoral chemo- Given the state-of-the-art in clinical and surgical oncology, and the advances that have been made in intratumoral drug delivery, minimally invasive tumour access i.e. ne needle biopsy, new drugs and drug delivery systems, and preoperative chemotherapy, it is timely to present a review of studies which may suggest future opportunities for safer, more effective, and clinically practical non-systemic therapy. General perspective for traditional systemic therapiesThe toxicity of conventional systemic cancer chemotherapy and immunotherapy has severely limited the safety and eOE ectiveness of such therapy. The quality of life

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“…Massive hemoptysis also remains a concern, particularly with brachytherapy (15). Celikoglu and colleagues have observed and reported that direct injection of chemotherapeutic agents via needlecatheter into endobronchial tumors is effective at achieving airway patency and has long-lasting effect (16)(17)(18).…”

mentioning

confidence: 99%

Restoration of Patency to Central Airways Occluded by Malignant Endobronchial Tumors Using Intratumoral Injection of Cisplatin

et al. 2015

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Rationale: Malignant airway obstruction is commonly found in patients with lung cancer and is associated with significant morbidity and mortality. Relieving malignant obstruction may improve symptoms, quality of life, and life expectancy.Objectives: The objective of this study was to analyze our experience with bronchoscopic endobronchial intratumoral injection of cisplatin for malignant airway obstruction. Methods:We conducted a retrospective analysis of patients with malignant airway obstruction treated with bronchoscopic intratumoral injection of cisplatin. Patient characteristics, histology, degree of airway obstruction, procedural methods, treatment cycles, performance status, and therapeutic outcomes were evaluated. Tumor response was analyzed based on bronchoscopic measurements performed on completion the of final treatment session. Adverse events and overall survival were abstracted. Measurements and Main Results:Between January 2009 and September 2014, 22 patients (10 men, 12 women; mean age 6 SD, 64.4 6 9.5 yr) were treated with one to four injections of 40 mg of cisplatin mixed in 40 ml of 0.9% NaCl. Treatments were completed 1 week apart. The primary etiologies of airway obstruction included squamous cell carcinoma (n = 11), adenocarcinoma (n = 6), small cell carcinoma (n = 2), large cell undifferentiated carcinoma (n = 1), and metastatic endobronchial cancer (n = 2). Twenty-one of 22 patients were evaluable for response. The majority of patients (15/21, 71.4%) responded to therapy, defined as greater than 50% relative reduction in obstruction from baseline. Treatment response was obtained regardless of tumor histology, concurrent systemic therapy, number of treatment cycles administered, performance status, or use of additional ablative interventions. Responders had significantly improved overall survival as compared with nonresponders, although the difference was small. Severe treatment-related side effects or complications were not observed.Conclusions: Subject to the limitations of a single-center retrospective study and a subjective primary outcome measure, we have demonstrated the feasibility of improving the patency of central airways that are largely or completely occluded by endobronchial malignant tumor using intraluminal injection of cisplatin. Additional longer-term, larger-scale safety and comparative effectiveness studies of this palliative treatment modality are warranted.

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Direct injection of anti-cancer drugs into endobronchial tumours for palliation of major airway obstruction

Cited by 33 publications

References 5 publications

Intratumoral administration of cisplatin through a bronchoscope followed by irradiation for treatment of inoperable non-small cell obstructive lung cancer

Intratumoral administration of cisplatin through a bronchoscope followed by irradiation for treatment of inoperable non-small cell obstructive lung cancer

Intratumoral cancer chemotherapy and immunotherapy: opportunities for nonsystemic preoperative drug delivery

Restoration of Patency to Central Airways Occluded by Malignant Endobronchial Tumors Using Intratumoral Injection of Cisplatin

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