Transcatheter Arterial Chemoembolization Is a Feasible Palliative Locoregional Therapy for Breast Cancer Liver Metastases

Cho, Sung W.; Kitisin, Krit; Buck, David A.; Steel, Jennifer; Brufsky, Adam; Gillespie, R N Andrea; Tsung, Allan; Marsh, J. Wallis; Geller, David A.; Gamblin, T. Clark

doi:10.1155/2010/251621

Cited by 15 publications

(21 citation statements)

References 22 publications

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“…For example, in TACE, which uses vessel embolization to induce cancer tissue necrosis, surrounding tissue is also obliterated [30]. Furthermore, any remaining embolization- or radiotherapy-resistant cancer tissue tends to be more malignant and can lead to metastasis [55, 56].…”

Section: Resultsmentioning

confidence: 99%

“…However, these therapies not only affect solid tumors but also normal cells, which is an area of concern in cancer treatment [27]. Furthermore, cancer therapies, such as transarterial chemoembolization (TACE) that uses blood vessels may not produce the desired results, and this may even increase vascular proliferation and growth into a malignant tumor by incomplete responses [30]. A correlation between hypoxia, cancer proliferation, and angiogenesis and the mechanism of growth or development of tumors has been observed [31].…”

Section: Introductionmentioning

confidence: 99%

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Regulation of the hypoxic tumor environment in hepatocellular carcinoma using RNA interference

Choi

Park

2017

Cancer Cell Int

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ObjectivesHypoxia is the condition where tumor cells have been deprived of oxygen and has been shown to have a role of tumor development in the hepatocellular carcinoma (HCC).MethodsUsing PubMed online database and Google scholar web site, the terms “angiogenesis”, “apoptosis”, “RNA interference” and/or “hepatocellular carcinoma (HCC)” were searched and analyzed.ResultsThe hypoxia inducible factors (HIFs) are transcriptional regulators that affect a homeostatic response to oxidative stress and have been identified as a key transcription activator of angiogenesis, survival, and metabolism. Cytokines, such as IL-8, also controlled endothelia cells survival and angiogenesis. IL-8 was also overexpressed under hypoxia and induced tumor angiogenesis and growth.ConclusionTherefore, regulation of HIFs and IL-8 controlled the tumor microenvironment in terms of tumor angiogenesis and apoptosis. The review summarizes the results of regulation of the hypoxic tumor environment.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Regulation of the hypoxic tumor environment in hepatocellular carcinoma using RNA interference

Choi

Park

2017

Cancer Cell Int

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“…Though TACE may theoretically offer escalated local dosing or combinations of chemotherapeutics, therapeutic failure rates are high with PD in 51-60% of patients (42,43) even when multiple cytotoxic agents and dose selection are tailored to individual mBC patients based on their history of systemic treatment (43). Buijs et al reported 26% of treated lesions had partial RECIST response after multi-agent TACE yet 0 of 14 patients had a net partial response based on total tumor burden and the number of patients with stable or PD and toxicity were not specified (40).…”

Section: Discussionmentioning

confidence: 99%

Yttrium-90 Radioembolization Stops Progression of Targeted Breast Cancer Liver Metastases after Failed Chemotherapy

Gordon

Gradishar

Kaklamani

et al. 2014

Journal of Vascular and Interventional Radiology

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PURPOSE The purpose of this open-label, retrospective report was to determine the safety and effectiveness of locoregional therapy with yttrium-90 (90Y) radioembolization for patients with progressing breast cancer liver metastases (BCLM) despite polychemotherapy. MATERIALS & METHODS Seventy-five patients with progressing BCLM and stable extrahepatic disease were treated with radioembolization at our institution. Retrospective review of a prospectively collected database was performed to evaluate clinical and biochemical toxicities, tumor response, overall survival (OS), and time to progression (TTP). Radiologic response assessments included Response Evaluation Criteria in Solid Tumors in primary index lesions and metabolic activity on positron emission tomography. Univariate and multivariate analyses were performed. RESULTS 30-day mortality was 4% (n=3). Grade 3+ clinical toxicity and hyperbilirubinemia occurred in 7.6% (n=5) and 5.9% (n=4), respectively. The rate of partial response was 35.3% (n=24), 63.2% (n=43) had stable disease, and progressive disease occurred in 1.5% (n=1). PET imaging was available in 25 patients and 21 (84%) had a complete or partial response or stable disease. The median OS was 6.6mo (95% CI, 5.0 to 9.2mo). The hazard ratio (HR) for OS was .39 (95% CI, .23 to .66) for tumor burden <25% compared to greater tumor burden in multivariate analysis. Elevated bilirubin reduced OS. The HR for hepatic progression was .22 (95% CI, .05 to .98) for solitary compared to multifocal disease. CONCLUSIONS Locoregional therapy with 90Y radioembolization is safe and stops or delays the progression of targeted chemorefractory breast cancer liver metastases. Adverse prognosticators are identified.

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“…In addition, direct liver delivery may result in a better systemic toxicity profile. The chemotherapeutic effect of TACE on tumor cells is also increased by embolization-induced tumor ischemia [49]. Published data suggest that TACE may have a palliative role in delaying progression of isolated LiM.…”

Section: Local Treatment Of Selected Disease Sitesmentioning

confidence: 99%

Oligometastatic Breast Cancer: A Shift from Palliative to Potentially Curative Treatment?

Lascio

Pagani²

2014

Breast Care

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A distinctive subset of metastatic breast cancer is represented by the so called ‘oligometastatic' disease, characterized by single/few detectable metastatic lesions. A more aggressive multidisciplinary approach can be considered in this patient population: available data report favorable results of ‘radical' local therapy for limited metastatic disease at least in a subset of selected patients. Selection bias and the retrospective nature of data do not allow for generalization of the results: the use of such approaches must be individualized and managed within a multidisciplinary team of dedicated specialists. Improvement in surgical and radiation techniques, development of new tools to deliver local chemotherapy, and new procedures (i.e. cryosurgery, laser and microwave ablation) mandate careful evaluation of such single and combined modalities in controlled clinical trials. A more accurate identification of patients with limited metastases and better definition of treatment endpoints will also allow correct patient selection for locally aggressive therapies. This paper focusses on local treatment of the primary tumor and of the most frequent distant disease sites in the presence of oligometastatic disease.

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Transcatheter Arterial Chemoembolization Is a Feasible Palliative Locoregional Therapy for Breast Cancer Liver Metastases

Cited by 15 publications

References 22 publications

Regulation of the hypoxic tumor environment in hepatocellular carcinoma using RNA interference

Regulation of the hypoxic tumor environment in hepatocellular carcinoma using RNA interference

Yttrium-90 Radioembolization Stops Progression of Targeted Breast Cancer Liver Metastases after Failed Chemotherapy

Oligometastatic Breast Cancer: A Shift from Palliative to Potentially Curative Treatment?

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