EUS-guided injection of paclitaxel (OncoGel) provides therapeutic drug concentrations in the porcine pancreas (with video)

Matthes, Kai; Mino‐Kenudson, Mari; Sahani, Dushyant V.; Holalkere, Nagaraj-Setty; Fowers, Kirk D.; Rathi, Ramesh; Brugge, William R.

doi:10.1016/j.gie.2006.06.030

Cited by 129 publications

(52 citation statements)

References 14 publications

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“…Our results after local MNP injection in the pancreas showed no evidence of an important pancreatic reaction confirming that EUSguided injection is technically successful because of the nearby position of the pancreas near the gastric wall. Similar results were noted by Kai et al [19] who injected an OncoGel solution in a porcine pancreas tail and observed the deposits 14 days after exposure proving that the technique is feasible and could be a potential therapy for advanced pancreatic cancer.…”

Section: Discussionsupporting

confidence: 85%

Endoscopic ultrasound guided injection of iron oxide magnetic nanoparticles for liver and pancreas: a feasibility study in pigs.

et al. 2016

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Aims: Pancreatic cancer and hepatocellular carcinoma are two of the most aggressive types of cancer with limited therapeutic options in stages of advanced disease. Our objective is to assess the safety and feasibility of injecting iron oxide nanoparticles (IONs) via endoscopic ultrasound (EUS)-guidance, both systemically and locally in the liver and pancreas in order to study new potential therapies for liver and pancreatic tumors. Material and methods: Six domestic pigs were used for our study design, and divided into three groups: two were injected in the portal vein, and other four were subjected to local exposure of IONs in the liver and pancreas, two each. The pigs were on a 7 days follow-up and necropsy was performed with their organs harvested. A 3T MRI scan was also performed. Results: All animals underwent an endoscopic ultrasound fine needle injection (EUS-FNI) procedure without any complications. EUS-FNI procedure had an average time of 5 minutes and 21 seconds and consisted of 2 ml of ION injection. No perforations and no risk of potential bleeding were recorded. Macroscopic changes were observed only after pancreatic EUS-FNI. A significant amount of IONs was observed in the liver after local injection and after vascular EUS-FNI. The imaging results were confirmed by pathological examination with most of the IONs accumulated in Ito-like cells, Kupfer cells, and sinusoids. Conclusions: IONs have been widely studied for both diagnostic and therapeutic purposes. Their injection through EUS-guidance may develop new diagnosis strategies as well as curative or palliative therapies in pancreatic and liver tumors.

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Section: Discussionsupporting

confidence: 85%

Endoscopic ultrasound guided injection of iron oxide magnetic nanoparticles for liver and pancreas: a feasibility study in pigs.

et al. 2016

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“…Ablation therapies of cystic neoplasms have been proposed: EUS-guided injection of cytotoxic agents (e.g., paclitaxel, ethanol) and radiofrequency ablation. These procedures are not widely employed and their results are not defined and can be evaluated with difficulty, also because these ablation therapies have been used for various PCNs [37][38][39]. The results of surgical treatment for non-invasive disease are very positive with 5-year overall survival of 100%; for invasive disease, 5-year overall survival drops to 50-60% [28].…”

Section: Intraductal Papillary Mucinous Neoplasms (Ipmns)mentioning

confidence: 99%

Management of Pancreatic Cystic Lesions

Neri¹

2017

Challenges in Pancreatic Pathology

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Objectives: In the last several decades, the knowledge of the cystic neoplasms has enlarged and the management has changed. The wide adoption in the diagnostic procedures of routine and advanced imaging has become the cornerstone of the diagnosis.Methods: Pancreatic cystic tumors comprise neoplasms with a wide range of malignant potential. The most common include serous cystic neoplasm, mucinous cystic neoplasms (MCNs), intraductal papillary mucinous neoplasms (IPMNs), solid pseudopapillary neoplasms (SPPNs), and cystic pancreatic endocrine neoplasms (CPENs). Other cystic lesions are acute postnecrotic pseudocysts and chronic pseudocysts. Finally, the indeterminate cystic lesions have been presented. Results:The epidemiology, pathological features, imaging characteristics, clinical evolution, and therapeutic choices of the most frequent lesions as well as less frequent forms are described. This study can be completed with the presentation of some cases of cystic pancreatic neoplasms treated in our service. Conclusion:The improvement of imaging, endoscopic modalities, and cyst fluid studies allows now accurate and reliable diagnosis of pancreatic cystic lesions. Moreover, the enlarged knowledge of valuable pathological studies established the potential for malignant transformation of these lesions identifying higher-risk neoplasms. Finally, the management options should be based on the assessment of each type of cystic neoplasms and the distinction of pancreatic cystic neoplasms (PCNs) from other cystic lesions.

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“…We performed initial ex vivo experiments to develop and improve our technique of creating artificial tumors in the pancreas with endoscopic ultrasound (EUS), based on previous experience with pancreatic injection [26,27]. In six ex vivo specimens, we performed EUS-guided injections of ReGel, a thermosensitive alcohol copolymer (Protherics, Inc., Brentwood, TN), mixed with 1 ml of methylene blue, into the porcine pancreas in the EASIE-R Simulator (EndoSim, LLC, Berlin, MA).…”

Section: Ex Vivo Experimentsmentioning

confidence: 99%

Development of a pancreatic tumor animal model and evaluation of NOTES tumor enucleation

et al. 2011

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The creation of artificial pancreatic tumors via EUS guidance is feasible. Pancreatic tumor enucleation using a transgastric NOTES approach is technically feasible and could be an alternative to laparoscopic distal pancreatectomy with further development. Further adoption and adaptation of this technique will require the development of more sophisticated specialized tools to improve the safety profile of the procedure.

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EUS-guided injection of paclitaxel (OncoGel) provides therapeutic drug concentrations in the porcine pancreas (with video)

Cited by 129 publications

References 14 publications

Endoscopic ultrasound guided injection of iron oxide magnetic nanoparticles for liver and pancreas: a feasibility study in pigs.

Endoscopic ultrasound guided injection of iron oxide magnetic nanoparticles for liver and pancreas: a feasibility study in pigs.

Management of Pancreatic Cystic Lesions

Development of a pancreatic tumor animal model and evaluation of NOTES tumor enucleation

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