Transvenous pulmonary chemoembolization (TPCE) for palliative or neoadjuvant treatment of lung metastases

Vogl, Thomas J.; Mekkawy, Ahmed; Thabet, Duaa B.; El-Sharkaway, Mostafa; Kamel, Hosam M.; Albrecht, Moritz H.; Naguib, N; Hassan, Afaf Abd El-Kader

doi:10.1007/s00330-018-5757-8

Cited by 13 publications

(18 citation statements)

References 30 publications

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“…Chemoembolization has been used successfully for treating primary and secondary liver malignancies, and it is under evaluation as a less invasive strategy for the treatment of lung malignancies (75). Since the first report in 2005 (76), TPCE has been used in limited cohorts as a locoregional technique for delivering chemotherapy in higher intratumoral concentrations and with reduced systemic toxicity (63,75), mainly with neoadjuvant or palliative intent. This method is performed via super-selective catheterization of the tumor-feeding pulmonary arteries, blocking them by injection of cytotoxic drugs mixed with lipiodol and microspheres.…”

Section: Discussionmentioning

confidence: 99%

“…Not unexpectedly, it has been recently studied in patients with hepatocellular carcinoma to treat intrathoracic metastatic spread (77). This technique may be employed either alone or prior to ablation in a multimodality strategy, with the aim to improve local disease control by eliminating eventual micrometastasis and reducing the need for a larger safety margin during subsequent percutaneous ablation (63,78).…”

Section: Discussionmentioning

confidence: 99%

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A narrative review on pulmonary metastases management by non-surgical local techniques: where do we stand?

Ierardi¹,

Carnevale²,

Chiarello³

et al. 2021

AME Surg J

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To analyze the existent evidence regarding local non-surgical therapies of lung metastases in terms of prognostic outcomes, control of disease and safety of treatment.Background: The rationale of local therapies for pulmonary metastases is either to increase the patient's chance of survival or cure the disease, depending on the origin and histology of the tumour. Metastasectomy still represents the preferred local treatment for lung metastases; however, due to the obvious drawbacks of almost any surgical intervention, many patients are not considered eligible for surgery.Methods: An extended search with a priori selection criteria was performed on the treatment of pulmonary metastases with stereotactic radiotherapy, percutaneous ablation via radiofrequency, microwaves, cryoablation (CRA) and chemoembolization. Two reviewers independently screened the titles and abstracts of all retrieved papers; the reference lists of eligible studies were checked with the aim to find further studies not identified by the initial search. After final selection, 52 original articles were included.Conclusions: A discrete number of minimally invasive non-surgical methods has been developed for tumor patients who are ineligible for surgical treatment. Among the available techniques, stereotactic radiotherapy and percutaneous ablation are currently the most commonly used local therapies. They have emerged as valid alternatives in case of surgical or medical inoperability, and may offer cancer patients the possibility for controlling unresectable pulmonary metastases with opportunities for improved survival.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A narrative review on pulmonary metastases management by non-surgical local techniques: where do we stand?

Ierardi¹,

Carnevale²,

Chiarello³

et al. 2021

AME Surg J

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“…Dadurch wird die Einlagerungszeit der injizierten Zytostatika Elektroporation in den Tumoren verlängert [24] und der Abfluss in den Kreislauf reduziert [10,23]. Folglich werden Häufigkeit und Schweregrad der systemischen Wirkungen begrenzt [25]. Andere verwendete Okklusionsmaterialien sind Coils, Polyvinylalkohol, abbaubare Stärkemikrokügelchen und Gelatineschwämme.…”

Section: Transpulmonale Chemoembolisation (Tpce)unclassified

“…Erste Ergebnisse zeigten, dass die lokale Kontrolle und das Überleben bei Patienten mit Lungenmetastasen verbessert werden können. Es konnten auch bessere Ergebnisse in Kombination mit einer ablativen Therapie als neoadjuvante Therapie erzielt werden [25]. Randomisierte kontrollierte Studien sind jedoch weiterhin erforderlich.…”

Section: Transpulmonale Chemoembolisation (Tpce)unclassified

Intravascular Treatment Techniques for Locoregional Therapies of Lung Tumors

Vogl

Mekkawy

Thabet

2023

Rofo

Self Cite

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Background Lung cancer incidence has greatly increased over the past century. Moreover, the lung is the most common site of metastatic involvement. Despite improvements in the diagnosis and treatment of lung malignancies, patient prognosis is still unsatisfactory. Locoregional chemotherapeutic techniques for the treatment of lung malignancies are the current focus of research. The aim of this review article is to present different locoregional intravascular techniques and their treatment principles and to assess the pros and cons of each of them as a palliative and neoadjuvant treatment method in the treatment of lung malignancy. Method The different methods for the treatment of malignant lung lesions such as isolated lung perfusion (ILP), selective pulmonary artery perfusion (SPAP), transpulmonary chemoembolization (TPCE), bronchial artery infusion (BAI), bronchioarterial chemoembolization (BACE), and intraarteriel chemoperfusion (IACP) are evaluated comparatively. Results Locoregional intravascular chemotherapy procedures are proving to be promising treatment options in the management of malignant lung tumors. In order to achieve optimal results, the locoregional technique should be used to achieve the highest possible uptake of the chemotherapeutic agent into the target tissue with rapid systemic clearance. Conclusion Among the various treatment options for lung malignancies, TPCE is the best evaluated treatment concept. However, further studies are necessary to define the optimal treatment concept with the best clinical outcomes. Key Points Citation Format

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“…cTACE and DEB-TACE is also increasingly being used in the treatment of liver metastasis (such as from colorectal or neuroendocrine tumors) [83,84], with chemoembolization of malignancies in other body parts also reported, either for preoperative down staging / vascularity reduction, or for palliation of painful lesions (such as bone metastasis). There are typically isolated reports or small series, with heterogeneous choice of embolic agent and outcome measures [85,86].…”

Section: Transarterial Chemo Embolisationmentioning

confidence: 99%

Loco-regional drug delivery in oncology: current clinical applications and future translational opportunities

Rossi

Murray

McDonough

et al. 2020

Expert Opinion on Drug Delivery

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IntroductionDrug-based treatment regimens for cancer are often associated with off-target toxic side effects and low penetration of the drug at the tumor site leading to patient morbidity and limited efficacy. Locoregional drug delivery has the potential to increase efficacy while concomitantly reducing toxicity. Areas coveredClinical applications using loco-regional delivery include intra-arterial drug delivery in retinoblastoma, direct intra-tumoral (IT) injection of ethanol for ablation in hepatocellular carcinoma (HCC) and the use of HIPEC in peritoneal carcinomas. In recent years, there has been a significant increase in both approved products and clinical trials, with a particular emphasis on drug delivery platforms such as drug eluting beads for HCC and hydrogel platforms for intravesical delivery in bladder cancer. Expert opinionDevelopment of loco-regional drug delivery systems has been slow, limited by weak clinical data for early applications and challenges relating to dosing, delivery and retention of drugs at the site of action. However, there is increasing focus on the potential of loco-regional drug delivery when combined with bespoke drug delivery platforms. With the growth in immunotherapies, the use of IT delivery to drive priming of the anti-tumor response has opened up a new field of opportunity for locoregional drug delivery.

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Transvenous pulmonary chemoembolization (TPCE) for palliative or neoadjuvant treatment of lung metastases

Cited by 13 publications

References 30 publications

A narrative review on pulmonary metastases management by non-surgical local techniques: where do we stand?

A narrative review on pulmonary metastases management by non-surgical local techniques: where do we stand?

Intravascular Treatment Techniques for Locoregional Therapies of Lung Tumors

Loco-regional drug delivery in oncology: current clinical applications and future translational opportunities

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