Image-Guided Percutaneous and Transarterial Therapies for Primary and Metastatic Lung Cancer

Abstract

Lung cancer is the leading cause of cancer mortality in the world. A significant proportion of patients with lung cancer are not candidates for surgery and must resort to other treatment alternatives. Rapid technological advancements in fields like interventional radiology have paved the way for valid treatment modalities like image-guided percutaneous and transarterial therapies for treatment of both primary and metastatic lung cancer. The rationale of ablative therapies relies on the fact that focused delivery of energy induces tumor destruction and pathological necrosis. Image-guided percutaneous thermal ablation therapies are established techniques in the local treatment of hepatic, renal, bone, thyroid, or uterine lesions. In the lung, the 3 main indications for lung ablation include local curative intent, a strategy to achieve a chemoholiday in oligometastatic disease, and recently, oligoprogressive disease. Transarterial therapies include a set of catheter-based treatments that involve delivering embolic and/or chemotherapeutic agents directed into the target tumor via the supplying arteries. This article provides a comprehensive review of the various techniques available and discusses their applications and associated complications in primary and metastatic lung cancer.

Intratumoral Injection of Large Surface Area Microparticle Taxanes in Carcinomas Increases Immune Effector Cell Concentrations, Checkpoint Expression, and Synergy with Checkpoint Inhibitors: A Review of Preclinical and Clinical Studies

“…In addition to genetic factors, heterogeneity from stroma, fibroblast recruitment, immune cell migration, matrix remodeling, and tumor-specific vasculature create nongenetic variability in the tumor landscape [ 41 , 43 , 46 ]. Although intra-arterial endovascular infusion of LSAM-PTX or LSAM-DTX could potentially facilitate intratumoral drug distribution, the blood–tumor barrier reduces tumoricidal response in regions of the tumor distal to vasculature [ 47 – 49 ]. For example, in subcutaneous PC-3 prostate cancer xenografts, doxorubicin concentrations following IV infusion decrease exponentially with increasing distance from blood vessels and failed to kill cancer cells [ 50 ].…”