Isolated Limb Perfusion for Unresectable Melanoma of the Extremities

Noorda, Eva M.

doi:10.1001/archsurg.139.11.1237

Cited by 78 publications

(37 citation statements)

References 27 publications

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“…36 Growth of a those tumors in a heterotypical location on the footpad allows an easy local administration of TNF as well as an assessment of tumor growth by simple measurements, mimicking peripheral tumors in humans which are treated with TNF perfusion. 25,26 In accordance with the results obtained in vitro, we have observed that combination of TNF with bortezomib significantly inhibited tumor growth and prolonged survival of animals bearing the C-26 tumors. Mice bearing LLC tumors responded in a similar way, despite an apparent lack of effects in vitro; however, we were unable to obtain data that were statistically significant due to ample variations in the volume of control tumors.…”

Section: Discussionsupporting

confidence: 86%

“…[17][18][19][20][21][22][23] Several cytokines, including tumor necrosis factor (TNF), have been tested as anticancer agents either alone or in combination with common chemotherapeutics. 24 TNF is used in the clinic for isolated limb perfusion in patients suffering from advanced soft tissue sarcomas and melanomas 25,26 or for isolated perfusion of metastases. 27 Binding of TNF to its type I receptor (TNFR1) results in initiation of the extrinsic apoptotic pathway via caspase-8 cleavage.…”

mentioning

confidence: 99%

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TNF potentiates anticancer activity of bortezomib (Velcade®) through reduced expression of proteasome subunits and dysregulation of unfolded protein response

Nowis

McConnell

Dierlam

et al. 2007

Intl Journal of Cancer

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Bortezomib (Velcade 1 ) exploits proteasome inhibition as a unique mechanism of anticancer activity. The effectiveness of bortezomib is, however, limited, therefore, the search for therapeutic regimens combining bortezomib with other agents. In the present work we demonstrate enhanced anticancer activity of bortezomib by its combination with tumor necrosis factor (TNF) in the experimental model of C-26 colon carcinoma in mice. This interaction likely relies on the induction of a dysregulated response to ER stress, leading to apoptosis of cancer cells, evidenced by caspase-3 cleavage, p53 accumulation as well as increased SAPK/JNK phosphorylation. ER stress induced by the combination of TNF and bortezomib is corroborated by upregulation of BiP, PDI and calnexin as well as cleavage of caspase-12; however, in contrast to the classic pathway, it is also associated with decreased phosphorylation of eIF2a and prevention of XBP-1 splicing. TNF prevented the upregulation of Hsp27 induced by bortezomib, which may contribute to enhanced ER stress. Moreover, TNF interfered with bortezomib-induced upregulation of distinct subunits of the 26S proteasome. Bortezomib concentration used in this study was not sufficient to prevent TNF from inducing nuclear translocation of p65/RelA; however, the combination of both agents reduced total p65/RelA levels. Combined treatment of tumor-bearing mice with bortezomib and TNF not only inhibited tumor growth but also significantly prolonged animal survival. Therefore, combination of bortezomib with TNF is an attractive option for further clinical studies. ' 2007 Wiley-Liss, Inc.

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Section: Discussionsupporting

confidence: 86%

mentioning

confidence: 99%

TNF potentiates anticancer activity of bortezomib (Velcade®) through reduced expression of proteasome subunits and dysregulation of unfolded protein response

Nowis

McConnell

Dierlam

et al. 2007

Intl Journal of Cancer

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“…157,158 Although other agents have been used for ILP, and many have yet to be tested, melphalan (L-phenylalanine mustard) is the cytotoxic agent most commonly used, often in combination with either actinomycin D or TNF-alfa. [158][159][160][161] Response rates after ILP have improved as the method has been refined. A large systematic review (n=2018 ILPs; 22 trials) found that for patients with unresectable stage IIIB-IIIC metastatic melanoma of the limbs, studies published between 1990 and 2008 reported a median overall response rate of 90% (range, 64%-100%) and a median complete response rate of 58% (range, 25%-89%).…”

Section: Regional Therapy: Isolated Limb Perfusion and Infusionmentioning

confidence: 99%

Melanoma, Version 2.2016, NCCN Clinical Practice Guidelines in Oncology

Coit¹,

Thompson²,

Algazi³

et al. 2016

J Natl Compr Canc Netw

218

167

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OverviewIn 2016, an estimated 76,380 patients will be diagnosed with and approximately 10,130 patients will die of melanoma in the United States.1 However, these figures for new cases may represent a substantial underestimate, as many superficial and in situ melanomas treated in the outpatient setting are not reported. The incidence of melanoma continues to increase dramatically, at an overall rate of 33% for men and 23% women from 2002 to 2006.2 Melanoma is increasing in men more rapidly than any other malignancy, and in women more rapidly than any other malignancy except lung cancer. AbstractThis selection from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Melanoma focuses on adjuvant therapy and treatment of in-transit disease, because substantial changes were made to the recommendations for the 2016 update. Depending on the stage of the disease, options for adjuvant therapy now include biochemotherapy and highdose ipilimumab. Treatment options for in-transit disease now include intralesional injection with talimogene laherparepvec (T-VEC), a new immunotherapy. These additions prompted reassessment of the data supporting older recommended treatment options for adjuvant therapy and in-transit disease, resulting in extensive revisions to the supporting discussion sections. J Natl Compr Canc Netw 2016;14(4):450-473 NCCN Categories of Evidence and ConsensusCategory 1: Based upon high-level evidence, there is uniform NCCN consensus that the intervention is appropriate. Category 2A: Based upon lower-level evidence, there is uniform NCCN consensus that the intervention is appropriate. Category 2B: Based upon lower-level evidence, there is NCCN consensus that the intervention is appropriate. Category 3: Based upon any level of evidence, there is major NCCN disagreement that the intervention is appropriate.All recommendations are category 2A unless otherwise noted.Clinical trials: NCCN believes that the best management for any cancer patient is in a clinical trial. Participation in clinical trials is especially encouraged. Please NoteThe NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ® ) are a statement of consensus of the authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult the NCCN Guidelines ® is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient's care or treatment. The National Comprehensive Cancer Network ® (NCCN ® ) makes no representation or warranties of any kind regarding their content, use, or application and disclaims any responsibility for their applications or use in any way. The full NCCN Guidelines for Melanoma are not printed in this issue of JNCCN but can be accessed online at NCCN.org.© National Comprehensive Cancer Network, Inc. 2016, All rights reserved. The NCCN Guidelines and the illustrations herein may not be reproduced in any form without the express written permission of NCCN. Disclosures for the NCCN Melanoma ...

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“…1 To date, we have treated more than 150 patients using this novel approach. Based on prior experience with selective IA chemotherapy for the treatment of ocular retinoblastoma, 2 and the high local control rates achieved with selective IA injection of chemotherapy in recurrent limb melanoma, 18 we postulated that SIAC with selective injection of melphalan in the arteries feeding the metastatic disease would be feasible and safe and might prove beneficial in achieving local control of the spinal tumor.…”

Section: Discussionmentioning

confidence: 99%

Spinal intraarterial chemotherapy: interim results of a Phase I clinical trial

Patsalides

Yamada

Bilsky

et al. 2016

SPI

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OBJECT Despite advances in therapies using radiation oncology and spinal oncological surgery, there is a subgroup of patients with spinal metastases who suffer from progressive or recurrent epidural disease and remain at risk for neurological compromise. In this paper the authors describe their initial experience with a novel therapeutic approach that consists of intraarterial (IA) infusion of chemotherapy to treat progressive spinal metastatic disease. METHODS The main inclusion criterion was the presence of progressive, metastatic epidural disease to the spine causing spinal canal compromise in patients who were not candidates for the standard treatments of radiation therapy and/or surgery. All tumor histological types were eligible for this trial. Using the transfemoral arterial approach and standard neurointerventional techniques, all patients were treated with IA infusion of melphalan in the arteries supplying the epidural tumor. The protocol allowed for up to 3 procedures repeated at 3- to 6-week intervals. Outcome measures included physiological measures: 1) periprocedural complications according to the National Cancer Institute’s Common Terminology Criteria for Adverse Events; and 2) MRI to assess for tumor response. RESULTS Nine patients with progressive spinal metastatic disease and cord compression were enrolled in a Phase I clinical trial of selective IA chemotherapy. All patients had metastatic disease from solid organs and were not candidates for further radiation therapy or surgery. A total of 19 spinal intraarterial chemotherapy (SIAC) procedures were performed, and the follow-up period ranged from 1 to 7 months (median 3 months). There was 1 serious adverse event (febrile neutropenia). Local tumor control was seen in 8 of 9 patients, whereas tumor progression at the treated level was seen in 1 patient. CONCLUSIONS These preliminary results support the hypothesis that SIAC is feasible and safe.

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Isolated Limb Perfusion for Unresectable Melanoma of the Extremities

Cited by 78 publications

References 27 publications

TNF potentiates anticancer activity of bortezomib (Velcade®) through reduced expression of proteasome subunits and dysregulation of unfolded protein response

TNF potentiates anticancer activity of bortezomib (Velcade®) through reduced expression of proteasome subunits and dysregulation of unfolded protein response

Melanoma, Version 2.2016, NCCN Clinical Practice Guidelines in Oncology

Spinal intraarterial chemotherapy: interim results of a Phase I clinical trial

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