Isolated Limb Infusion for Limb-Threatening, Unresectable Sarcoma: Past Progress, Current Applications, and Future Directions

DePalo, Danielle; Zager, Jonathan S.

doi:10.3390/jcm12124036

Cited by 3 publications

(3 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ILP, first described by Creech and Krementz in 1958, involves surgical isolation of the affected extremity with extracorporeal circulation to deliver heated chemotherapy at high concentrations that would not be tolerated systemically ( Figure 1 ) [ 57 , 58 , 59 ]. Continuous leakage monitoring and flow rate adjustments are conducted throughout the procedure to minimize the potential side effects of systemic escape from the chemotherapy [ 58 ]. The most common chemotherapy agent used for this perfusion is melphalan.…”

Section: Isolated Limb Perfusion Therapy For In-transit Metastasesmentioning

confidence: 99%

“…The most common chemotherapy agent used for this perfusion is melphalan. In the setting of bulky or recurrent disease, the addition of tumor necrosis-factor alpha (TNF-alpha) can be valuable, although this agent is not available in North America or Australia [ 58 ].…”

Section: Isolated Limb Perfusion Therapy For In-transit Metastasesmentioning

confidence: 99%

“…Response rates seem to be independent of BRAF mutational status [ 61 ]. ILP can be safely repeated, such as in patients with recurrent disease who achieved CR after their first ILP or patients not responding to other therapies, achieving similar response rates as first-time ILP procedures [ 58 , 61 ]. Studies comparing response rates to ILP based on the prior receipt of systemic immunotherapy have shown conflicting results [ 62 , 63 ].…”

Section: Isolated Limb Perfusion Therapy For In-transit Metastasesmentioning

confidence: 99%

See 2 more Smart Citations

Intralesional and Infusional Updates for Metastatic Melanoma

Dugan,

Shannon,

DePalo

et al. 2024

Cancers

Self Cite

View full text Add to dashboard Cite

Locoregionally advanced and metastatic melanoma represent a challenging clinical problem, but in the era of immune checkpoint blockade and intralesional and infusional therapies, more options are available for use. Isolated limb infusion (ILI) was first introduced in the 1990s for the management of advanced melanoma, followed by the utilization of isolated extremity perfusion (ILP). Following this, intralesional oncolytic viruses, xanthene dyes, and cytokines were introduced for the management of in-transit metastases as well as unresectable, advanced melanoma. In 2015, the Food and Drug Administration (FDA) approved the first oncolytic intralesional therapy, talimogene laherparepvec (T-VEC), for the treatment of advanced melanoma. Additionally, immune checkpoint inhibition has demonstrated efficacy in the management of advanced melanomas, and this improvement in outcomes has been extrapolated to aid in the management of in-transit metastatic disease. Finally, percutaneous hepatic perfusion (PHP), also approved by the FDA, has been reported to have a significant impact on the treatment of hepatic disease in uveal melanoma. While some of these treatments have less utility due to inferior outcomes as well as higher toxicity profiles, there are selective patient profiles for which these therapies carry a role. This review highlights intralesional and infusional therapies for the management of metastatic melanoma.

show abstract

Section: Isolated Limb Perfusion Therapy For In-transit Metastasesmentioning

confidence: 99%

Section: Isolated Limb Perfusion Therapy For In-transit Metastasesmentioning

confidence: 99%

Section: Isolated Limb Perfusion Therapy For In-transit Metastasesmentioning

confidence: 99%

See 1 more Smart Citation

Intralesional and Infusional Updates for Metastatic Melanoma

Dugan,

Shannon,

DePalo

et al. 2024

Cancers

Self Cite

View full text Add to dashboard Cite

show abstract

Advances in the management of regionally metastatic melanoma

Balsay-Patel,

Dugan,

Zager

2024

Surgical Oncology

View full text Add to dashboard Cite

Desmoid fibromatosis: interventional radiology (sometimes) to the rescue for an atypical disease

Garnon,

Cazzato,

Autrusseau

et al. 2024

British Journal of Radiology

View full text Add to dashboard Cite

Desmoid fibromatosis is a rare locally aggressive soft tissue tumor that is characterized as benign as it cannot metastasize. It was managed until recently like sarcomas, i.e with radical surgical resection combined or not with radiotherapy. However, this approach was associated with a high rate of recurrence and significant morbidity. The management of this disease has progressively changed to a more conservative approach given the fact that desmoid fibromatosis may spontaneously stop to grow or even shrink in more than half of the cases. Should treatment be required, recent guidelines recommend choosing between systemic therapies, which include principally chemotherapy and tyrosine kinase inhibitors, and local treatments. And this is where the interventional radiologist may have an important role to treat the disease. Various ablation modalities have been reported in the literature to treat desmoid fibromatosis, notably high-intensity focused ultrasound and cryoablation. Results are promising and cryoablation is now mentioned in recent guidelines. The interventional radiologist should nevertheless apprehend the disease in its globality to understand the place of percutaneous treatments among the other therapeutic options. The goal of this review is therefore to present and discuss the role of interventional radiology (IR) in the management of DF.

show abstract

Isolated Limb Infusion for Limb-Threatening, Unresectable Sarcoma: Past Progress, Current Applications, and Future Directions

Cited by 3 publications

References 29 publications

Intralesional and Infusional Updates for Metastatic Melanoma

Intralesional and Infusional Updates for Metastatic Melanoma

Advances in the management of regionally metastatic melanoma

Desmoid fibromatosis: interventional radiology (sometimes) to the rescue for an atypical disease

Contact Info

Product

Resources

About