Pirarubicin-loaded CalliSpheres® drug-eluting beads for the treatment of patients with stage III–IV lung cancer

Abstract

Background CalliSpheres® beads (CB) have been used recently for patients with hepatocellular carcinoma. However, the safety and effect of drug-eluting bead transarterial chemoembolization (DEB-TACE) in patients with stage III–IV lung cancer are still unknown. Purpose To evaluate the safety and efficacy of DEB-TACE with pirarubicin-loaded CB for the treatment of stage III–IV lung cancer. Material and Methods From July 2016 to April 2020, 29 patients with stage III–IV primary lung cancer underwent DEB-TACE with pirarubicin-loaded CB. The objective response rate (ORR) was the primary endpoint; the secondary endpoints were progression-free survival (PFS) and overall survival (OS). Results Twenty-nine patients received DEB-TACE with pirarubicin-loaded (median 60 mg) CB, with no severe adverse events or treatment-related deaths. After DEB-TACE, hemoptysis disappeared within 1–3 days in all patients, and the symptoms of cough or expectoration were significantly improved in 12 patients. ORR and disease control rate at one, three, and six months after DEB-TACE were 39.3% and 96.4%, 26.1% and 69.6%, and 29.4% and 58.8%, respectively. The median PFS was 6.3 months (range 1.1–30.1 months), and the three-, six-, and 12-month PFS rates were 70.2%, 50.1%, and 27.1%, respectively. The median OS was 10.2 months (range 1.1–44.6 months), and the three-, six, and 12-month OS rates were 87.9%, 68.6%, and 39.8%, respectively. Conclusion DEB-TACE with pirarubicin-loaded CB is safe, feasible, and well-tolerated for patients with stage III–IV lung cancer, and symptom control was a potential benefit of treatment.

Drug-Eluting Bead Bronchial Arterial Chemoembolization With and Without Microwave Ablation for the Treatment of Advanced and Standard Treatment-Refractory/Ineligible Non-Small Cell Lung Cancer: A Comparative Study

“…( 14 ) analyzed 23 advanced lung cancer patients treated with DEB-BACE and revealed an ORR of 78.3% and median OS of 15.6 months despite including four patients with small cell lung cancer or lung metastases. Another study from this institution showed median PFS and OS of 6.3 months and 10.2 months, respectively, for 29 advanced NSCLC patients treated with pirarubicin-loaded DEB-BACE ( 15 ). Nevertheless, there was no consensus on the optimal chemotherapeutic drug loaded in the DEB microsphere.…”

“…DEB microspheres can provide a higher local drug concentration while reducing the systemic drug concentration and toxicity (11). Several studies have identified the efficacy and safety of DEB-BACE in advanced lung cancer and found a median PFS of 6.3-11.0 months and a median OS of 8.0-16.5 months (12)(13)(14)(15)(16). Gemcitabine-loaded DEB-BACE was first to be applied to NSCLC in 2019 (13).…”

“…As a novel drug delivery and embolization system in transarterial chemoembolization (TACE), drug-eluting bead (DEB) microsphere can release the loaded chemotherapeutic drugs slowly, improve local drug concentration, and permanently embolize the tumor-feeding arteries (11). DEB-BACE was identified as an effective and safe approach for advanced standard treatment-ineligible/rejected NSCLC (12)(13)(14)(15)(16).…”

Transarterial chemoembolization of unresectable renal cell carcinoma with doxorubicin-loaded CalliSpheres drug-eluting beads

“…Currently, DEB-TACE has been widely used in the treatment of unresectable carcinoma of substantial organs (e.g. liver 6 , 7 , uterus 8 or lung 9 ) rather than cavity organs such as bladder and digestive tract 3 , 15 . Our results indicated that DEB-TACE using doxorubicin-loaded CB is feasible, safe and showed good short-term efficacy without serious adverse events.…”

“…Emulsions of chemotherapeutic drugs and lipiodol were usually used in traditional TACE; however, drugs can neither release slowly nor reside long enough time 2 As a novel drug delivery and embolization system, drug-eluting beads TACE (DEB-TACE) is able to release drugs slowly into the malignant tissue after embolizing the tumor-feeding arteries 3 – 5 . CalliSpheres beads (CB) has been used recently for patients with hepatocellular carcinoma 6 , 7 , uterus 8 or lung 9 . In animal study, CB can effectively and safely embolize porcine renal artery 10 .…”