Evaluation of the Plasmatic and Parenchymal Elution Kinetics of Two Different Irinotecan-Loaded Drug-Eluting Embolics in a Pig Model

Gnutzmann, Daniel; Mechel, J; Schmitz, Änne; Köhler, Kernt; Krone, D.; Bellemann, Nadine; Gockner, Theresa; Mokry, Theresa; Kortes, Nikolas; Sommer, CM; Kauczor, Hans‐Ulrich; Radeleff, Boris; Stampfl, Ulrike

doi:10.1016/j.jvir.2014.12.016

Cited by 22 publications

(9 citation statements)

References 21 publications

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“…In cTACE, cytotoxic chemotherapy is injected into the artery, which is then embolized with permanent agents (for example, polyvinyl alcohol particles) that are often size calibrated to target a specific arterial level . In DSM‐TACE, one or more cytotoxic agents are mixed with DSM‐TACEs, causing a temporary arterial occlusion . DEB‐TACE combines the two methods: permanent embolic agents are coated with cytotoxic therapies allowing for a controlled release of the drug into the tissues over hours or days.…”

Section: Regional Therapiesmentioning

confidence: 99%

“…160,161 In DSM-TACE, one or more cytotoxic agents are mixed with DSM-TACEs, causing a temporary arterial occlusion. 162 170 Radioembolization as salvage treatment is the most studied indication, with response rates of 17%-35% and stable disease in 61%-81% and median overall survival of 10 to 13 months. 171,172 Three phase III trials investigating radioembolization as first-line therapy for unresectable colorectal liver metastases were performed in 14 countries worldwide comparing systemic chemotherapy with systemic therapy and radioembolization.…”

Section: Livermentioning

confidence: 99%

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Historical perspective: Two decades of progress in treating metastatic colorectal cancer

Lee

Cardona

Russell

2019

Journal of Surgical Oncology

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Colorectal cancer is the third most commonly diagnosed cancer in the United States. While screening methods strive to improve rates of early stage detection, 25% of patients have metastatic disease at the time of diagnosis, with the most common sites being the liver, lung, and peritoneum. While once perceived as hopeless, the last two decades have seen substantial strides in the medical, surgical, and regional therapies to treat metastatic disease offering significant improvements in survival.

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Section: Regional Therapiesmentioning

confidence: 99%

Section: Livermentioning

confidence: 99%

Historical perspective: Two decades of progress in treating metastatic colorectal cancer

Lee

Cardona

Russell

2019

Journal of Surgical Oncology

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“…After injection of DEBs, there is a controlled drug-release over several hours, and even days, within the treated tissue ( Fig. 1) [41]. Since type and dose of the chemotherapeutic can be selected individually and combined with a particular microsphere size and volume, DEB-TACE is considered as the most standardized procedure among TACE technologies.…”

Section: Chemoembolicsmentioning

confidence: 99%

Transarterial chemoembolization (TACE) for colorectal liver metastases—current status and critical review

Maßmann

Rodt

Marquardt

et al. 2015

Langenbecks Arch Surg

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There is encouraging data with regard to technical success, safety, and oncologic efficacy of TACE for colorectal liver metastases. The majority of studies are non-randomized single-center series mostly after failure of systemic therapies in the 2nd line and beyond. Emerging techniques including embolization with calibrated microspheres, with or without additional cytotoxic drugs, degradable starch microspheres, and technical innovations, e.g., cone-beam computed tomography (CT) allow a new highly standardized TACE procedure. The real efficacy of TACE for colorectal liver metastases in a neoadjuvant, adjuvant, and palliative setting has now to be evaluated in prospective randomized controlled trials.

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“…In this context, embolization with the smallest available embolic agents, such as iodized oil (Lipiodol Ultra-Fluide; Guerbet, Roissy, France) and microspheres (e.g., Embozene 40 [CeloNova BioSciences, San Antonio, USA/Boston Scientific, Marlborough, USA]) bear the risk of complications, such as bile duct injury due to occlusion of the peribilliary plexus, non-target embolization due to arterio-venous shunts or occult arterial collateralization, and fulminant tumor necrosis with subsequent embolism of necrotic tissue [ 2 , 8 , 9 ]. In order to obtain a controllable level of distal arterial occlusion, narrow-size calibrated small microspheres with a defined and uniform diameter of ≤75μm are increasingly being used [ 6 , 7 , 10 ]. Embozene 40 and Tandem 40 microspheres (CeloNova BioSciences, San Antonio, USA/Boston Scientific, Marlborough, USA) are currently the smallest commercially available permanent microspheres that are clinically used for transarterial embolization [ 2 , 8 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Animal models have been shown to be suitable for preclinical evaluation of the characteristics of embolic agents, such as visibility, vascular distribution, and effects on the treated tissue [ 7 , 10 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

Computed tomography and histopathological findings after embolization with inherently radiopaque 40μm-microspheres, standard 40μm-microspheres and iodized oil in a porcine liver model

Vollherbst

Gockner

et al. 2018

PLoS ONE

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PurposeThe present study compared standard computed tomography (CT) and histopathological findings after endovascular embolization using a prototype of inherently radiopaque 40μm-microspheres with both standard 40μm-microspheres and iodized oil in a porcine liver model.Materials and methodsTwelve pigs were divided into six study groups, of two pigs each. Four pigs were embolized with iodized oil alone and four with radiopaque microspheres; two animals in each group were sacrificed at 2 hours and two at 7 days. Two pigs were embolized with radiopaque microspheres and heparin and sacrificed at 7 days. Two pigs were embolized with standard microspheres and sacrificed at 2 hours. CT was performed before and after segmental embolization and before sacrifice at 7 days. The distribution of embolic agent, inflammatory response and tissue necrosis were assessed histopathologically.ResultsRadiopaque microspheres and iodized oil were visible on standard CT 2 hours and 7 days after embolization, showing qualitatively comparable arterial and parenchymal enhancement. Quantitatively, the enhancement was more intense for iodized oil. Standard microspheres, delivered without contrast, were not visible by imaging. Radiopaque and standard microspheres similarly occluded subsegmental and interlobular arteries and, to a lesser extent, sinusoids. Iodized oil resulted in the deepest penetration into sinusoids. Necrosis was always observed after embolization with microspheres, but never after embolization with iodized oil. The inflammatory response was mild to moderate for microspheres and moderate to severe for iodized oil.ConclusionRadiopaque 40μm-microspheres are visible on standard CT with qualitatively similar but quantitatively less intense enhancement compared to iodized oil, and with a tendency towards less of an inflammatory reaction than iodized oil. These microspheres also result in tissue necrosis, which was not observed after embolization with iodized oil. Both radiopaque and standard 40μm-microspheres are found within subsegmental and interlobar arteries, as well as in hepatic sinusoids.

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Evaluation of the Plasmatic and Parenchymal Elution Kinetics of Two Different Irinotecan-Loaded Drug-Eluting Embolics in a Pig Model

Cited by 22 publications

References 21 publications

Historical perspective: Two decades of progress in treating metastatic colorectal cancer

Historical perspective: Two decades of progress in treating metastatic colorectal cancer

Transarterial chemoembolization (TACE) for colorectal liver metastases—current status and critical review

Computed tomography and histopathological findings after embolization with inherently radiopaque 40μm-microspheres, standard 40μm-microspheres and iodized oil in a porcine liver model

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