Cryoablation Combined with Molecular Target Therapy Improves the Curative Effect in Patients with Advanced Non-Small Cell Lung Cancer

Abstract

This study investigated the curative effect of cryoablation combined with molecular target therapy for advanced non-small cell lung cancer (NSCLC). Thirty-six female patients with NSCLC and epidermal growth factor receptor gene mutations were randomly divided into two groups: 18 patients received the molecular target therapy gefitinib (group I), an epidermal growth factor receptor-tyrosine kinase inhibitor; and 18 patients were treated with cryoablation prior to the administration of gefitinib (group II). Treatment with gefitinib was continued for 6 months. Compared with group I, the rates of partial regression, stabilization of disease and progression of disease were improved in group II at the end of the 6 months of gefitinib treatment. Moreover, the 1-year survival rate in group II was significantly higher than that in group I. This suggests that cryoablation therapy combined with gefitinib could improve the effects of treatment and the prognosis of patients with advanced NSCLC.

Cryoablation and immunotherapy: an overview of evidence on its synergy

“…Additional phase II/III trials must be conducted to reveal the potential benefits in larger patient groups before combination treatment is considered an alternative [80]. Another strategy, consisting of a combination of cryoablation with gefitinib, an inhibitor of epidermal growth factor receptor’s (EGFR) tyrosine kinase domain, showed significant improvement of overall response with a higher 1-year survival rate in patients treated with gefitinib and cryoablation compared to gefitinib alone [81]. Lastly, 166 metastatic NSCLC patients received either cryoablation alone, cryoablation followed by immunotherapy (DC-CIK) or chemotherapy or all three therapies.…”

Primary tumors of the lung: should we consider thermal ablation as a valid therapeutic option?

“…Percutaneous cryoablation of advanced NSCLC has been combined with molecular targeted therapy. In a small, randomized controlled trial, 36 nonsmoking female patients with stages IIIB and IV, EGFR-activating mutation-positive NSCLC received either percutaneous cryoablation before initiation of gefitinib therapy (n ¼ 18) or gefitinib alone (n ¼ 18) [38]. 'Neoadjuvant' cryoablation followed by gefitinib was associated with greater rates of partial regression (55.6% vs. 27.8%), longer progression-free survival (8.4 months vs. 5.2 months) and a significantly better 1-year survival rate (66.7% vs. 33.3) than with gefitinib alone.…”

Immunological Aspects of Cryoablation of Non–Small Cell Lung Cancer: A Comprehensive Review

“…"Neoadjuvant" cryoablation followed by gefitinib was associated with greater rates of partial regression (55.6% versus 27.8%), longer progression-free survival (8.4 months versus 5.2 months), and increased 1-year survival rate (66.7% versus 33.3) than with gefitinib alone. 16 Immune analysis before and after treatment was not performed, and the mechanisms for how this combined therapy can have synergistic effects have not yet been explored. A larger prospective clinical trial investigating cryoablation with the EGFR tyrosine kinase inhibitor icotinib for treatment of EGFR activating mutation-positive NSCLC is currently ongoing (ClinicalTrials.gov identifier NCT02744664) ( Table 3).…”

“…In a murine model, cryoablation of lung cancer with peritumoral lipopolysaccharide (LPS) administration elicited robust antitumor immune responses. 12 The addition of cryoablation to certain lung cancer treatment regimens has demonstrated enhanced treatment efficacy (Tables 1 [12][13][14][15] and 2 [16][17][18][19] ). The effectiveness of cryoablation with ICIs in advanced NSCLC is currently unknown.…”