A Phase II Study of Biodegradable Stents Plus Palliative Radiotherapy in Oesophageal Cancer

Maishman, Tom; Sheikh, Hamid Y; Boger, Philip; Kelly, Jamie; Cozens, Kelly; Bateman, Adrian C.; Davies, Sarah; Fay, Michael; Sharland, D.; Jackson, A

doi:10.1016/j.clon.2020.12.010

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…The role of BDS in the management of malignant esophageal strictures is not adequately defined, and in such scenarios, BDS is not yet considered a valid alternative to SEMS. Studies have evaluated outcomes of BDS in patients undergoing single dose brachytherapy [20], palliative radiotherapy [21], and neoadjuvant treatment or radical radiotherapy [22], but in each of these studies, despite adequate technical success and short-term dysphagia symptom improvement, unacceptably high rates of adverse events and complications (retrosternal pain, vomiting, epithelial hyperplasia, and stent-related death), stent dysfunction, and need for reintervention were reported [20][21][22]. To overcome these limitations, BDS using novel materials (elastic and biodegradable mixed polymer of Poly(ε-caprolactone) (PCL) and poly(tri-methylene carbonate) (PTMC) as the coated membrane on magnesium alloy stents) are being developed but have not yet been tested in humans [23,24].…”

Section: Biodegradable Stentsmentioning

confidence: 99%

Futuristic Developments and Applications in Endoluminal Stenting

Ferreira‐Silva

Medas

Girotra

et al. 2022

Gastroenterology Research and Practice

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Endoscopic stenting is a well-established option for the treatment of malignant obstruction, temporary management of benign strictures, and sealing transmural defects, as well as drainage of pancreatic fluid collections and biliary obstruction. In recent years, in addition to expansion in indications for endoscopic stenting, considerable strides have been made in stent technology, and several types of devices with advanced designs and materials are continuously being developed. In this review, we discuss the important developments in stent designs and novel indications for endoluminal and transluminal stenting. Our discussion specifically focuses on (i) biodegradable as well as (ii) irradiating and drug-eluting stents for esophageal, gastroduodenal, biliary, and colonic indications, (iii) endoscopic stenting in inflammatory bowel disease, and (iv) lumen-apposing metal stent.

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Section: Biodegradable Stentsmentioning

confidence: 99%

Futuristic Developments and Applications in Endoluminal Stenting

Ferreira‐Silva

Medas

Girotra

et al. 2022

Gastroenterology Research and Practice

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“… Yano et al (2017) confirmed that BDS is an efficient and well-tolerated therapeutic choice for RBES that occurs after esophageal cancer treatment, particularly following ESD or CRT; however, its long-term efficacy remains limited. In 2021, Maishman et al (2021) employed the SIMON two-stage, single-arm, prospective phase II trial design to assess the efficacy of biodegradable stents in combination with radiotherapy in patients with esophageal cancer-related dysphagia who were not candidates for radical interventions. The observed elevated intervention rates indicate that the proposed alternative treatments may not be sufficiently efficacious to justify their inclusion in larger-scale trial designs.…”

Section: Materials Used In Biodegradable Esophageal Stentsmentioning

confidence: 99%

Comprehensive review of materials, applications, and future innovations in biodegradable esophageal stents

Yang,

Hou

et al. 2023

Front. Bioeng. Biotechnol.

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Esophageal stricture (ES) results from benign and malignant conditions, such as uncontrolled gastroesophageal reflux disease (GERD) and esophageal neoplasms. Upper gastrointestinal endoscopy is the preferred diagnostic approach for ES and its underlying causes. Stent insertion using an endoscope is a prevalent method for alleviating or treating ES. Nevertheless, the widely used self-expandable metal stents (SEMS) and self-expandable plastic stents (SEPS) can result in complications such as migration and restenosis. Furthermore, they necessitate secondary extraction in cases of benign esophageal stricture (BES), rendering them unsatisfactory for clinical requirements. Over the past 3 decades, significant attention has been devoted to biodegradable materials, including synthetic polyester polymers and magnesium-based alloys, owing to their exceptional biocompatibility and biodegradability while addressing the challenges associated with recurring procedures after BES resolves. Novel esophageal stents have been developed and are undergoing experimental and clinical trials. Drug-eluting stents (DES) with drug-loading and drug-releasing capabilities are currently a research focal point, offering more efficient and precise ES treatments. Functional innovations have been investigated to optimize stent performance, including unidirectional drug-release and anti-migration features. Emerging manufacturing technologies such as three-dimensional (3D) printing and new biodegradable materials such as hydrogels have also contributed to the innovation of esophageal stents. The ultimate objective of the research and development of these materials is their clinical application in the treatment of ES and other benign conditions and the palliative treatment of malignant esophageal stricture (MES). This review aimed to offer a comprehensive overview of current biodegradable esophageal stent materials and their applications, highlight current research limitations and innovations, and offer insights into future development priorities and directions.

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