Local drug delivery to a human pancreatic tumor via a newly designed multiple injectable needle

Ohara, Koji; Kohno, Masayuki; Horibe, Tomohisa; Kawakami, Koji

doi:10.3892/mco.2012.47

Cited by 6 publications

(3 citation statements)

References 8 publications

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“…EUS, however, is associated with the need for sedation, which may add additional cost and risks associated with sedation. Further studies are needed to compare and firmly establish the most effective EUS-FNI delivery technique including the use of multiple injection sites within the tumor, multiple passes, or use of newer designed needle devices for enhanced dispersion of the agents within the desmoplastic pancreatic stroma[ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound-guided injectable therapy for pancreatic cancer: A systematic review

Kaur¹,

Jaruvongvanich²,

Chandrasekhara³

2022

WJG

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BACKGROUND Given the low survival rate in pancreatic cancer, new therapeutic techniques have been explored, especially for unresectable or borderline resectable disease. Endoscopic ultrasound (EUS) provides real-time imaging and minimally invasive access for local and targeted injection of anti-tumor agents directly into the pancreatic tumor. Limited studies have been reported using this technique for the treatment of pancreatic ductal adenocarcinoma (PDAC). AIM To evaluate the progress made with EUS-guided injectable therapies in the treatment of PDAC. METHODS All original articles published in English until July 15, 2021, were retrieved via a library-assisted literature search from Ovid Evidence-Based Medicine Reviews and Scopus databases. Reference lists were reviewed to identify additional relevant articles. Prospective clinical studies evaluating the use of EUS-guided injectable therapies in PDAC were included. Studies primarily directed at non-EUS injectable therapies and other malignancies were excluded. Retrieved manuscripts were reviewed descriptively with on critical appraisal of published studies based on their methods and outcome measures such as safety, feasibility, and effectiveness in terms of tumor response and survival. Heterogeneity in data outcomes and therapeutic techniques limited the ability to perform comparative statistical analysis. RESULTS A total of thirteen articles (503 patients) were found eligible for inclusion. The EUS-injectable therapies used were heterogeneous among the studies consisting of immunotherapy ( n = 5) in 59 patients, chemotherapy ( n = 1) in 36 patients, and viral and other biological therapies ( n = 7) in 408 patients. Eleven of the studies reviewed were single armed while two were double armed with one randomized trial and one non-randomized comparative study. Overall, the included studies demonstrated EUS-guided injectable therapies to be safe and feasible with different agents as monotherapy or in conjunction with other modalities. Promising results were also observed regarding their efficacy and survival parameters in patients with PDAC. CONCLUSION EUS-guided injectable therapies, including immunotherapy, chemotherapy, and viral or other biological therapies have shown minimal adverse events and potential efficacy in the treatment of PDAC. Comparative studies, including controlled trials, are required to confirm these results in order to offer novel EUS-based treatment options for patients with PDAC.

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Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound-guided injectable therapy for pancreatic cancer: A systematic review

Kaur¹,

Jaruvongvanich²,

Chandrasekhara³

2022

WJG

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“…Furthermore, although the EUS-FNI technique has been used for the local delivery of antitumor agents, a single injection is definitely insufficient. Ohara et al [ 31 ] have designed multiple injectable needles, and their data showed that they increased the distribution of injected drugs compared with a single-point injection. Therefore, future studies will evaluate multiple ethanol injections to treat pancreatic cancer using EUS-FNI.…”

Section: Discussionmentioning

confidence: 99%

Antitumor Activity of Intratumoral Ethanol Injection in an Orthotopic Pancreatic Cancer Cell Mouse Xenograft Model

Zhang

Jin

Liu

et al. 2018

Gastroenterology Research and Practice

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Purpose Pancreatic cancer is a lethal disease and usually is diagnosed at advanced stages of disease. This study assessed the effects of intratumoral ethanol injection using an endoscopic ultrasound (EUS) probe on the control of pancreatic cancer in a mouse orthotopic xenograft model. Materials and Methods The subcutaneous and orthotopic human pancreatic cancer cell mouse xenograft models were established. Different concentrations of ethanol (0–95%) were injected into subcutaneous xenograft tumors. In the orthotopic tumor model, ethanol was injected into the tumor lesions under the guidance of a high-frequency EUS probe. Tumor volume, relative tumor volume (RTV), and histopathology were evaluated. The serum amylase level was analyzed at baseline and 24 h after treatment in the orthotopic tumor model. Results Injection of 40–95% ethanol induced tumor necrosis in the subcutaneous tumor model, while there was no statistical difference between the RTVs of the two groups (P = 0.81). In the orthotopic tumor model, the RTV of the 80% ethanol treatment group was less than that of the saline injection group (P < 0.01); and histologically, there was a large area of necrosis observed in the 80% ethanol group. The serum amylase level was slightly elevated at 24 h after injection and returned to the baseline level at 7 days. Conclusion Injection of 80% ethanol into xenograft tumor lesions of orthotopic pancreatic cancer resulted in tumor necrosis, and the procedure was safe and effective. Future studies will further confirm its antitumor activity as well as assess its safety and feasibility.

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“…It is also possible to improve the localised drug delivery to tumours through the manipulation of injectable devices. Ohara et al has improved the Endoscopic Ultrasound-guided Fine Needle Injection (EUS-FNI) technique, with a newly designed ‘Multiple Injectable Needle’ (MIN), to deliver drugs to refractory pancreatic tumours [ 107 ]. MIN consists of a manipulatable 25-gauge inner needle embedded in a 19-gauge rotatable outer needle, capable of injecting a potential drug into the tumour in multiple directions at a puncture site.…”

Section: Locoregional Therapiesmentioning

confidence: 99%

Pancreatic Cancer: Challenges and Opportunities in Locoregional Therapies

Bazeed

Day

Garg

2022

Cancers

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Pancreatic cancer (PC) remains the seventh leading cause of cancer-related deaths worldwide and the third in the United States, making it one of the most lethal solid malignancies. Unfortunately, the symptoms of this disease are not very apparent despite an increasing incidence rate. Therefore, at the time of diagnosis, 45% of patients have already developed metastatic tumours. Due to the aggressive nature of the pancreatic tumours, local interventions are required in addition to first-line treatments. Locoregional interventions affect a specific area of the pancreas to minimize local tumour recurrence and reduce the side effects on surrounding healthy tissues. However, compared to the number of new studies on systemic therapy, very little research has been conducted on localised interventions for PC. To address this unbalanced focus and to shed light on the tremendous potentials of locoregional therapies, this work will provide a detailed discussion of various localised treatment strategies. Most importantly, to the best of our knowledge, the aspect of localised drug delivery systems used in PC was unprecedentedly discussed in this work. This review is meant for researchers and clinicians considering utilizing local therapy for the effective treatment of PC, providing a thorough guide on recent advancements in research and clinical trials toward locoregional interventions, together with the authors’ insight into their potential improvements.

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Local drug delivery to a human pancreatic tumor via a newly designed multiple injectable needle

Cited by 6 publications

References 8 publications

Endoscopic ultrasound-guided injectable therapy for pancreatic cancer: A systematic review

Endoscopic ultrasound-guided injectable therapy for pancreatic cancer: A systematic review

Antitumor Activity of Intratumoral Ethanol Injection in an Orthotopic Pancreatic Cancer Cell Mouse Xenograft Model

Pancreatic Cancer: Challenges and Opportunities in Locoregional Therapies

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