Late Breaking Abstract - Bronchoscopic microwave ablation of peripheral lung tumors

Lau, Kelvin; Lau, Rainbow W. H.; Baranowski, Ralitsa; Ng, Calvin S.H.

doi:10.1183/13993003.congress-2021.oa230

Cited by 6 publications

(8 citation statements)

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“…The possibility of a lower complication rate for a transbronchial versus transthoracic approach [15,16], together with the development of more sophisticated navigational bronchoscopic and imaging modalities, has spurred interest in transbronchial thermal ablation of lung cancers [17,18]. Preliminary studies with transbronchial-delivered RFA of early-stage NSCLC have provided promising short-term results [19,20], but clinical experience with transbronchial MWA (tMWA) remains limited to retrospective single-center observations and conference proceedings [21][22][23]. Preclinical studies have assessed the radiological and histological aspects of tMWA-induced lung tissue damage and recovery [24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Novel Image-Guided Flexible-Probe Transbronchial Microwave Ablation for Stage 1 Lung Cancer

Pritchett¹,

Reisenauer²,

Kern³

et al. 2023

Respiration

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Background: Image-guided percutaneous thermal ablation is an established treatment option for early-stage lung cancer in medically inoperable patients but carries a high risk of pleura-related complications, particularly pneumothorax. Objective: This study aimed to determine if image-guided transbronchial microwave ablation (tMWA) is a feasible approach to treat peripheral stage 1 lung cancer. Method: A prospective, single-arm, multicenter study sought to enroll 40 adults who were medically inoperable or declined surgery for peripheral stage 1 lung tumors (≤20 mm). Ablation was performed using navigational bronchoscopy and a flexible MWA probe, guided by cone-beam CT with augmented fluoroscopy. Follow-up at 1, 6, and 12 months included CT imaging of the ablation zone and possible tumor recurrence, adverse events (AEs), pulmonary function, and quality of life. Results: Across 2 sites, 11 tumors (10 NSCLC, 1 carcinoid) were treated in 10 enrolled patients. Median tumor diameter was 13 × 14 mm (7–19 mm) and median minimum ablative margin was 11 mm (5–19 mm). Technical success and technique efficacy were achieved in all patients. No tumor recurrence was seen during 12-month follow-up. No pneumothorax, pleural effusion, or bronchopleural fistula were noted. Minor AEs included scant hemoptysis, pain, cough, and dyspnea. Two serious AEs occurred ≤30 days of ablation and included a COPD exacerbation (day 9) and a death of unknown cause (day 15). The death led the sponsor to halt enrollment. Pulmonary function and quality-of-life indices remained stable. Conclusions: Image-guided tMWA is a technically feasible approach for peripheral early-stage lung cancer but warrants further evaluation of safety and efficacy in larger cohorts.

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Section: Introductionmentioning

confidence: 99%

Novel Image-Guided Flexible-Probe Transbronchial Microwave Ablation for Stage 1 Lung Cancer

Pritchett¹,

Reisenauer²,

Kern³

et al. 2023

Respiration

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“…At the ERS congress 2021, L au et al . [ 4 ] presented MWA of peripheral lung tumours in the NAVABLATE study as a late-breaking abstract. This prospective study used MWA in combination with navigation bronchoscopy to target PPNs <30 mm.…”

Section: Group 1401: Interventional Pulmonologymentioning

confidence: 99%

“…One patient experienced mild haemoptysis as an adverse event, possibly related to the ablation device as it occurred in the first 30 days. At 1 month, technique efficacy was 100%, and the planned 2-year follow-up regarding efficacy is in progress [ 4 ].…”

Section: Group 1401: Interventional Pulmonologymentioning

confidence: 99%

ERS International Congress 2021: highlights from the Clinical Techniques, Imaging and Endoscopy Assembly

et al. 2022

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This manuscript summarises the highlights from the virtual European Respiratory Society's “Clinical techniques, imaging and endoscopy” Assembly 14 presented at the 2021 European Respiratory Society International Congress. Cutting-edge innovative developments in both diagnostic approaches and therapeutic strategies in patients with lung cancer, interstitial lung disease, obstructive airway disorders and infectious diseases were presented on this year's interactive congress platform. In this manuscript, the Assembly 14 subgroups summarise the key take home messages given new research outcomes and place them in the context of the current knowledge.

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“…Adverse events were common (70%) but mostly mild in severity, and included pleuritic pain, pleural effusion, and site infection in one patient. 21…”

Section: Bronchoscopic Microwave Ablationmentioning

confidence: 99%

“…Adverse events were common (70%) but mostly mild in severity, and included pleuritic pain, pleural effusion, and site infection in one patient. 21 The publication by Chan et al described the retrospective single-center experience with transbronchial MWA with electromagnetic navigation (EMN) bronchoscopy in 30 nodules in 25 high surgical risk patients. With the median follow-up of 12 months, none of the nodules had evidence of progression.…”

Section: Bronchoscopic Microwave Ablationmentioning

confidence: 99%

Therapeutic Bronchoscopy for Lung Nodules: Where Are We Now?

Folch

Guo

Senitko

2022

Semin Respir Crit Care Med

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Lobar resection has been the established standard of care for peripheral early-stage non—small cell lung cancer (NSCLC). Over the last few years, surgical lung sparing approach (sublobar resection [SLR]) has been compared with lobar resection in T1N0 NSCLC. Three nonsurgical options are available in those patients who have a prohibitive surgical risk, and those who refuse surgery: stereotactic body radiotherapy (SBRT), percutaneous ablation, and bronchoscopic ablation. Local ablation involves placement of a probe into a tumor, and subsequent application of either heat or cold energy, pulsing electrical fields, or placement of radioactive source under an image guidance to create a zone of cell death that encompasses the targeted lesion and an ablation margin. Despite being in their infancy, the bronchoscopic ablative techniques are undergoing rapid research, as they extrapolate a significant knowledge-base from the percutaneous techniques that have been in the radiologist's armamentarium since 2000. Here, we discuss selected endoscopic and percutaneous thermal and non-thermal therapies with the focus on their efficacy and safety.

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Late Breaking Abstract - Bronchoscopic microwave ablation of peripheral lung tumors

Cited by 6 publications

References 0 publications

Novel Image-Guided Flexible-Probe Transbronchial Microwave Ablation for Stage 1 Lung Cancer

Novel Image-Guided Flexible-Probe Transbronchial Microwave Ablation for Stage 1 Lung Cancer

ERS International Congress 2021: highlights from the Clinical Techniques, Imaging and Endoscopy Assembly

Therapeutic Bronchoscopy for Lung Nodules: Where Are We Now?

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