Intratumoral cisplatin/epinephrine-injectable gel as a palliative treatment for accessible solid tumors: A multicenter pilot study☆☆☆★★★

Abstract

Intratumoral injections of cisplatin/epinephrine-injectable gel were administered weekly for 4 weeks in 45 patients with malignant tumors of various histologic types. Tumors were located on the skin and subcutaneous tissue primarily of the head, neck, and trunk, and on the tongue, oral pharynx, and esophagus. Patients were not candidates for surgery, radiation, or systemic chemotherapy. Each of the treated tumors (n = 82) was evaluated 2, 4, 8, and 12 weeks after the final injection. The initial dose of cisplatin was 1 mg/cm3 tumor volume, with escalation to 6 mg/cm3 allowed, depending on observed toxicities. The mean cumulative dose per patient for the four treatments ranged from 0.56 to 380 mg cisplatin. No dose-limiting cisplatin-related toxicities, such as nephrotoxicity, neurotoxicity, or ototoxicity, were observed. The overall objective tumor response rate was 50% (41 of 82), with 40% (33 of 82) complete responses and a median response duration of 160 days. Complete responses for adenocarcinoma and squamous cell carcinoma were 58% (21 of 36) and 38% (12 of 32), respectively. These results justified further clinical trials to evaluate the role of local chemotherapy with intratumoral cisplatin/epinephrine-injectable gel in the palliative treatment of patients with selected accessible solid tumors.

Intratumoral administration of cisplatin through a bronchoscope followed by irradiation for treatment of inoperable non-small cell obstructive lung cancer

“…Moreover, intratumoral chemotherapy with cisplatin has been successfully used by IT injection in the treatment of a variety of localized malignant tumors. It has been administered by direct injection in head and neck cancers [28], by CAT scan guided injection in malignant liver tumors [29], by injection through endoscopes for the palliation of obstructive cancer of esophagus [21], and by injection into gastric tumors [30]. For these reasons we preferred to use cisplatin in the present study as the chemotherapeutic agent for bronchoscopic intratumoral chemotherapy.…”

Controlled release of doxorubicin from pH-responsive microgels

“…Because of this, researchers have evaluated local and regional chemotherapy as either a primary or adjuvant approach to control malignancies [1]. A clinical study has shown that 50% of solid tumors responded to treatment with intratumoral chemotherapy using an injectable gel to administer the drug into the tumors [2]. Polymers have been used to tailor drug release so that the drug concentration is maintained within the desired therapeutic range.…”

Laser and cisplatinum for treatment of human squamous cell carcinoma

“…Previous efforts to improve local tumor response and minimize systemic effects by injecting CDDP directly into tumors have not been effective, since hematogenous diffusion of the drug appears to rapidly diminish intratumor drug levels 7,9,10 . In an effort to prolong high intratumor drug levels, CDDP recently has been combined with epinephrine in a collagen gel as an intralesional therapeutic vehicle 11,12 …”