The safety and efficacy of oxaliplatin-loaded drug-eluting beads transarterial chemoembolization for the treatment of unresectable or advanced lung cancer

Abstract

Aim: Drug-eluting beads are usually applied for the treatment of advanced hepatocellular carcinoma. Oxaliplatin was suggested as first-line therapy for advanced non–small-cell lung cancer. However, there has been little investigation about the application of drug-eluting beads transarterial chemoembolization (DEB-TACE) with oxaliplatin-loaded CalliSpheres beads (CB) for the treatment of unresectable or advanced lung cancer. We aimed to investigate the safety and efficacy of oxaliplatin-loaded DEB-TACE for the treatment of unresectable or advanced lung cancer.Methods: From January 2019 to December 2021, all patients with primary unresectable or advanced lung cancer who underwent DEB-TACE with oxaliplatin-loaded CB were retrospectively enrolled. This study defined overall survival and objective response rate (ORR) as the primary endpoints, disease control rate (DCR) and progression-free survival (PFS) as the secondary endpoints.Results: A total of 33 sessions of DEB-TACE were performed in 20 patients, with a mean of 1.7 ± 1.0 sessions. A total of 55 arteries were emoblized by CB, including 40 bronchial arteries, 13 intercostal arteries, one suprarenal artery and one inferior phrenical artery. No procedural-related mortality or severe complications were observed. The median tumor diameter was 49.0 [Interquartile range (IQR) 37.8–66.8] mm before DEB-TACE, and decreased to 38.8 (IQR 27.7–56.9), 26.1 (IQR 19.1–48.8), and 20.5 (IQR 13.1–49.7) mm at 1, 3 and 6 months later (p = 0.04). The ORR and DCR at 1, 3, and 6 months after DEB-TACE were 28.6% and 92.9%, 38.5% and 84.6%, 30.8% and 61.5%, respectively. The median PFS and median overall survival was 9.9 and 29.6 months, respectively.Conclusion: DEB-TACE with oxaliplatin-loaded CB is suggested as a safe, effective and well-tolerated treatment for patients with unresectable or advanced lung cancer.

Drug-eluting beads bronchial arterial chemoembolization in advanced and standard treatment-refractory/ineligible NSCLC

“…A multicenter prospective study had showed drug-eluting beads loaded with epirubicin for D-BACE was effective and safe in treating refractory NSCLC 20 . In this study, we also used epirubicin for loading DC Bead™ particles, while oxaliplatin, vinorelbine, and gemcitabine have been reported for loading CalliSpheres beads, which are commonly used for lung cancer in systemic chemotherapy [23][24][25] .…”

Image-Guided Percutaneous and Transarterial Therapies for Primary and Metastatic Lung Cancer

“…67,70 Drug-eluting beads TACE (DEB-TACE), a recent novel technique, aims to solve this problem by taking advantage of the slow and sustained release of the chemotherapy from the beads into the local tumor environment. 67,[71][72][73] Moreover, different kinds of drugs can be used for DEB-TACE, such as doxorubicin, 74 gemcitabine, 67,75 oxaliplatin, 76,77 and pirarubicin. 78 These methods work because the lung has a dual blood supply, as previously described.…”

Editorial: Local ablative therapies for the management of lung cancer

“…For advanced and standard treatments-refractory NSCLC patients, local treatment of drug-eluting beads bronchial arterial chemoembolization (DEB-BACE) could be an option ( 8 , 9 ), also for treating complications. When DEB-BACE was combined with MWA, superior ORR and longer PFS were achieved as showed by Xu et al.…”