Regional Chemotherapy of the Lung: Transpulmonary Chemoembolization in Malignant Lung Tumors

Vogl, Thomas J.; Shafinaderi, Mohammad; Zangos, S; Lindemayr, Sebastian; Vatankhah, Khashayar

doi:10.1055/s-0033-1342959

Cited by 32 publications

(1 citation statement)

References 41 publications

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“…These methods provide localized tumor directed treatment and alleviate many of the complicating side-effects associated with systemic (whole-body) approaches or surgical intervention. In the treatment of lung cancer, transpulmonary chemoembolization has proven successful as an interventional technique, yet has questionable impact on overall patient survival (Lindemayr et al, 2007;Vogl et al, 2013). We propose our framework of coupling tumor vascular supply to tumor metabolism as a method for screening for patients that are likely to respond to tumor directed therapies.…”

Section: Tumor Directed Therapies and Embolizationmentioning

confidence: 99%

Cancer as a Model System for Testing Metabolic Scaling Theory

Brummer

Savage

2021

Front. Ecol. Evol.

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Biological allometries, such as the scaling of metabolism to mass, are hypothesized to result from natural selection to maximize how vascular networks fill space yet minimize internal transport distances and resistance to blood flow. Metabolic scaling theory argues two guiding principles—conservation of fluid flow and space-filling fractal distributions—describe a diversity of biological networks and predict how the geometry of these networks influences organismal metabolism. Yet, mostly absent from past efforts are studies that directly, and independently, measure metabolic rate from respiration and vascular architecture for the same organ, organism, or tissue. Lack of these measures may lead to inconsistent results and conclusions about metabolism, growth, and allometric scaling. We present simultaneous and consistent measurements of metabolic scaling exponents from clinical images of lung cancer, serving as a first-of-its-kind test of metabolic scaling theory, and identifying potential quantitative imaging biomarkers indicative of tumor growth. We analyze data for 535 clinical PET-CT scans of patients with non-small cell lung carcinoma to establish the presence of metabolic scaling between tumor metabolism and tumor volume. Furthermore, we use computer vision and mathematical modeling to examine predictions of metabolic scaling based on the branching geometry of the tumor-supplying blood vessel networks in a subset of 56 patients diagnosed with stage II-IV lung cancer. Examination of the scaling of maximum standard uptake value with metabolic tumor volume, and metabolic tumor volume with gross tumor volume, yield metabolic scaling exponents of 0.64 (0.20) and 0.70 (0.17), respectively. We compare these to the value of 0.85 (0.06) derived from the geometric scaling of the tumor-supplying vasculature. These results: (1) inform energetic models of growth and development for tumor forecasting; (2) identify imaging biomarkers in vascular geometry related to blood volume and flow; and (3) highlight unique opportunities to develop and test the metabolic scaling theory of ecology in tumors transitioning from avascular to vascular geometries.

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Section: Tumor Directed Therapies and Embolizationmentioning

confidence: 99%

Cancer as a Model System for Testing Metabolic Scaling Theory

Brummer

Savage

2021

Front. Ecol. Evol.

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Mechanism of tumour vascularization in experimental lung metastases

Szabó

Bugyik

Dezső

et al. 2014

The Journal of Pathology

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SP are co-senior and co-corresponding authors to this study. AbstractThe appearance of lung metastases is associated with poor outcome and the management of patients with secondary pulmonary tumours remains a clinical challenge. We examined the vascularization process of lung metastasis in six different preclinical models and found that the tumours incorporated the pre-existing alveolar capillaries (ie vessel co-option). During the initial phase of vessel co-option, the incorporated capillaries were still sheathed by pneumocytes, but these incorporated vessels subsequently underwent different fates dependent on the model. In five of the models examined (B16, HT1080, HT25, C26, and MAT B-III), the tumour cells gradually stripped the pneumocytes from the vessels. These dissected pneumocytes underwent fragmentation, but the incorporated microvessels survived. In the sixth model (C38), the tumour cells failed to invade the alveolar walls. Instead, they induced the development of vascularized desmoplastic tissue columns. Finally, we examined the process of arterialization in lung metastases and found that they became arterialized when their diameter grew to exceed 5 mm. In conclusion, our data show that lung metastases can vascularize by co-opting the pulmonary microvasculature. This is likely to have important clinical implications, especially with respect to anti-angiogenic therapies.

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The evidence for and against different modes of tumour cell extravasation in the lung: diapedesis, capillary destruction, necroptosis, and endothelialization

Paku

László

Dezső

et al. 2017

The Journal of Pathology

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The development of lung metastasis is a significant negative prognostic factor for cancer patients. The extravasation phase of lung metastasis involves interactions of tumour cells with the pulmonary endothelium. These interactions may have broad biological and medical significance, with potential clinical implications ranging from the discovery of lung metastasis biomarkers to the identification of targets for intervention in preventing lung metastases. Because of the potential significance, the mechanisms of tumour cell extravasation require cautious, systematic studies. Here, we discuss the literature pertaining to the proposed mechanisms of extravasation and critically compare a recently proposed mechanism (tumour cell-induced endothelial necroptosis) with the already described extravasation mechanisms in the lung. We also provide novel data that may help to explain the underlying physiological basis for endothelialization as a mechanism of tumour cell extravasation in the lung.

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Regional Chemotherapy of the Lung: Transpulmonary Chemoembolization in Malignant Lung Tumors

Cited by 32 publications

References 41 publications

Cancer as a Model System for Testing Metabolic Scaling Theory

Cancer as a Model System for Testing Metabolic Scaling Theory

Mechanism of tumour vascularization in experimental lung metastases

The evidence for and against different modes of tumour cell extravasation in the lung: diapedesis, capillary destruction, necroptosis, and endothelialization

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