Prospective Multicentered Safety and Feasibility Pilot for Endobronchial Intratumoral Chemotherapy

The survival of patients with head and neck squamous cancer with locoregional recurrence is short if salvage surgery or radiation cannot be performed. Systemic chemotherapy based on platinum salts and cetuximab produces only partial and transient responses. Immune checkpoint inhibitors (i.e., nivolumab) lead to a low complete response rate of only about 10%, but in some cases the effects can be long-lasting. Intratumoral chemotherapy (ITC) has been proposed for patients with local recurrence of head and neck squamous cell carcinoma with an objective response rate of 27–50%. However, it often leads to peritumoral tissue necrosis, and the duration of local control is limited. Here, we present 2 patients with head and neck squamous cell cancer whose local recurrences were refractory to intravenous chemotherapy and nivolumab. ITC using nonnecrotizing molecules, associated with nivolumab, led to complete stable local and distant response. ITC seems to trigger tumor resensitization to previously ineffective immunotherapy. This combination deserves an evaluation in the framework of a prospective trial.

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Fine Needle Percutaneous Intratumoral Chemotherapy under Ultrasound Guidance: A Feasibility Study

Tumori Journal ◽

10.1177/030089168607200112 ◽

1986 ◽

Vol 72 (1) ◽

pp. 81-87 ◽

Cited By ~ 20

Author(s):

Tito Livraghi ◽

Emilio Bajetta ◽

Luigi Matricardi ◽

Eugenio Villa ◽

Roberta Lovati ◽

...

Keyword(s):

Feasibility Study ◽

Ultrasound Guidance ◽

Fine Needle ◽

Intratumoral Chemotherapy

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Cystic craniopharyngioma: intratumoral chemotherapy with alpha interferon

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2011000100011 ◽

2011 ◽

Vol 69 (1) ◽

pp. 50-55 ◽

Cited By ~ 19

Author(s):

Patrícia Alessandra Dastoli ◽

Jardel Mendonça Nicácio ◽

Nasjla Saba Silva ◽

Andrea Maria Capellano ◽

Silvia R.C. Toledo ◽

...

Keyword(s):

Side Effects ◽

Interferon Alpha ◽

Tumor Volume ◽

Response To Treatment ◽

Lower Percentage ◽

Intratumoral Chemotherapy ◽

Cystic Craniopharyngioma ◽

Tumor Reduction ◽

One Year

OBJECTIVE: To assess whether the cystic craniopharyngiomas can be controlled with the use of intratumoral applications of interferon alpha. METHOD: Nineteen patients with the diagnosis of cystic craniopharyngioma were treated with intratumoral chemotherapy with interferon alpha from January 2002 to April 2006. All patients underwent placement of an intracystic catheter connected to an Ommaya reservoir. Through this reservoir were made applications during chemotherapy cycles. Each cycle corresponded to application of 3,000,000 units of interferon alpha three times per week on alternate days totalizing 36,000,000 units. Response to treatment was evaluated by calculating the tumor volume on MRI control after one, three and six months after the end of each cycle. Patients who developed worsening of symptoms or who had insignificant reduction in tumor volume during follow-up underwent repeat cycle chemotherapy. RESULTS: Four patients received four cycles of chemotherapy, three patients received three cycles, six patients received two cycles and six patients received one. The lower percentage of reduction in tumor volume was 60% and the bigger reduction was 98.37%. Eleven patients had a reduction greater than 90%. Five patients had a tumor reduction between 75 and 90% and in three patients the tumors were reduced by less than 75%. No deaths occurred during treatment and side effects of interferon alpha were well tolerated. No treatment was discontinued. Follow-up after the last application ranged from one year and five months to three years and nine months. CONCLUSION: The intratumoral chemotherapy with interferon alpha decreases the volume of cystic craniopharyngiomas and so far can be considered a new therapeutic alternative.

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The efficacy of bronchoscopic intratumoral chemotherapy in palliation of inoperable lung cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e17556 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e17556-e17556

Author(s):

Hesham El Ghazaly ◽

Tamer Mohammed ◽

Ashraf Madkour ◽

Emad Koraa

Keyword(s):

Lung Cancer ◽

Airway Obstruction ◽

Invasive Procedure ◽

Blood Gases ◽

Karnofsky Performance Scale ◽

Bronchial Obstruction ◽

Systemic Complications ◽

Intratumoral Chemotherapy ◽

Arterial Blood ◽

Life Threatening

e17556 Background: Endobronchial obstruction is a common complication of advanced-stage lung cancer. Patients presenting with severe bronchial obstruction are at a high risk for developing haemoptysis, post-obstructive pneumonia, or respiratory failure, this often leads to death in weeks to months.Tumor debulking and airway re-canalization has a considerable role in increasing survival in patients with inoperable non-small cell lung cancer (NSCLC). Bronchoscopic endobronchial intratumoral chemotherapy (EITC) is a new intervention to treat airway obstruction. This work aims to determine the efficacy of EITC in palliative care for patients with inoperable NSCLC. Methods: Between April 2009 and June 2011, patients with newly diagnosed non metastatic inoperable symptomatic non-life threatening airway obstruction secondary to NSCLC were selected for tumor debulking via EITC through flexible bronchoscopy. EITC of maximum 20mL cisplatin with the concentration of 50 mg/50 mL was injected into the tumor bulk through flexible needle (weekly for 4 sessions). Patients were followed according to the symptoms, performance and functional status and endobronchial lesions changes after EITC. Results: Forteen male and 1 female were studied in which 7 cases had squamous cell carcinoma, 5 cases had adenocarcinoma and 3 cases had unspecified NSCLC. After 4 sessions of EITC, the involved lumen was considerably opened (> 25%) in 80% of cases in which 7 cases >50% and 5 cases showed a 25–50% luminal opening. Significant improvement was found in dyspnea score, Karnofsky performance scale as well as spirometric and arterial blood gases indices after than before the 4 sessions of EITC. Conclusions: EITC was well tolerated by most of the patients with minimal non systemic complications. In conclusion, EITC is a promising, safe, effective and less invasive procedure for palliative treatment of obstructive non-life threatening endobronchial NSCLC lesions.

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Long-term outcome associated with intratumoral chemotherapy with cisplatin for cutaneous tumors in equidae: 573 cases (1995–2004)

Journal of the American Veterinary Medical Association ◽

10.2460/javma.230.10.1506 ◽

2007 ◽

Vol 230 (10) ◽

pp. 1506-1513 ◽

Cited By ~ 71

Author(s):

Alain P. Théon ◽

W. David Wilson ◽

K. Gary Magdesian ◽

Nicola Pusterla ◽

Jack R. Snyder ◽

...

Keyword(s):

Term Outcome ◽

Long Term Outcome ◽

Intratumoral Chemotherapy

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Hemiballismus as a complication of an intratumoral chemotherapy catheter

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2016.01.031 ◽

2016 ◽

Vol 30 ◽

pp. 129-131 ◽

Cited By ~ 2

Author(s):

Britton Zuccarelli ◽

Brian Aalbers ◽

Paul Grabb

Keyword(s):

Intratumoral Chemotherapy

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INTRATUMORAL CHEMOTHERAPY AS AN ADJUCT TO ENDOBRONCHIAL BRACHYTHERAPY

CHEST Journal ◽

10.1378/chest.132.4_meetingabstracts.459 ◽

2007 ◽

Vol 132 (4) ◽

pp. 459A ◽

Cited By ~ 1

Author(s):

Daniel A. Nader

Keyword(s):

Intratumoral Chemotherapy

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Revisiting bronchoscopic intratumoral chemotherapy in malignant central airway obstruction via EUS-B approach and its review of literature

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2020.1324 ◽

2020 ◽

Vol 90 (4) ◽

Author(s):

Ram Niwas ◽

Gopal Chawla ◽

Puneet Pareek ◽

Nishant Kumar Chauhan ◽

Naveen Dutt

Keyword(s):

Airway Obstruction ◽

Rigid Bronchoscopy ◽

Endobronchial Ultrasound ◽

Atlantoaxial Instability ◽

Jet Ventilation ◽

Central Airway Obstruction ◽

Intratumoral Chemotherapy ◽

Airway Stenting ◽

Central Airway ◽

Tracheal Tumors

Critical central airway obstruction has always been a dreaded complication to which interventional pulmonologist commonly encounters. There have been various modalities which are used for the management and palliation, which includes mechanical coring, laser, cryoextraction, electrocautery and airway stenting. Rigid bronchoscopy with or without jet ventilation has been corner stone of therapeutics and palliation of central airway obstruction. There are only a few conditions where it is not possible to use rigid bronchoscopy. Here we report a case of metastatic tracheal tumour which presented with critical airway obstruction in a patient who had atlantoaxial instability (AAI) due to rheumatoid arthritis. Here we used endobronchial ultrasound scope (EBUS) via esophageal route, i.e. EUS-B guided approach for sampling of the tracheal tumour, and intratumoral chemotherapy was instilled in multiple sessions, which resulted in shrinking of tumour, thus relieving the critical airway obstruction. This is the first report of using EUS-B approach for intratumoral chemotherapy for tracheal tumors. Bronchoscopic intratumoral chemotherapy therapy (BITC) in tracheal tumors is also one of the options but has not been explored much and there has been a dearth of literature for it.

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