Interventional Radiology for Local Immunotherapy in Oncology

Abstract

Human intratumoral immunotherapy (HIT-IT) is under rapid development, with promising preliminary results and high expectations for current phase III trials. While outcomes remain paramount for patients and the referring oncologists, the technical aspects of drug injection are critical to the interventional radiologist to ensure optimal and reproducible outcomes. The technical considerations for HIT-IT affect the safety, efficacy, and further development of this treatment option. Image-guided access to the tumor allows the therapeutic index of a treatment to be enhanced by increasing the intratumoral drug concentration while minimizing its systemic exposure and associated on-target off-tumor adverse events. Direct access to the tumor also enables the acquisition of cancer tissue for sequential sampling to better understand the pharmacodynamics of the injected immunotherapy and its efficacy through correlation of immune responses, pathologic responses, and imaging tumor response. The aim of this article is to share the technical insights of HIT-IT, with particular consideration for patient selection, lesion assessment, image guidance, and technical injection options. In addition, the organization of a standard patient workflow is discussed, so as to optimize HIT-IT outcome and the patient experience.

Hyperthermia and Tumor Immunity

“…The generation of ICD has been identified in multiple locoregional cancer therapies including radiation therapy [ 18 ], direct intratumoral immunotherapies [ 41 , 42 , 43 ] and hyperthermia [ 40 ]. One potential advantage of hyperthermia over radiation is the absence of lymphopenia that can follow radiation therapy [ 44 , 45 , 46 ].…”

Study on the Correlation Factors of Tumour Prognosis after Intravascular Interventional Therapy

“…However, different research data support that the ratio of tumour length to tumour neck width (AR) and hypertension are included as prognostic factors. L. Tselikas pointed out that, due to different locations, the prognosis of anterior and posterior circulation tumours is significantly different after interventional therapy [ 10 ]. However, most previous studies related to prognostic factors involve multisite tumours and lack pertinence to the location of tumours.…”

Immunotherapy and Interventional Radiology (IR): Time to Change the Paradigm—Keynote Lecture PAIRS 2021

“…Do we need delivery platform, as suggested by early animal experiment? 8,10,11 IRs must investigate other intratumoral routes such as intralymphatic and intra-arterial. Maybe in the future, we can inject in size of the particle theory.…”