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Drug-Loaded Microspheres for the Treatment of Liver Cancer: Review of Current Results

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Abstract

Transarterial chemoembolization (TACE) involves the emulsification of a chemotherapeutic agent in a viscous drug carrier, delivered intra-arterially to liver tumor for maximum effect. TACE reduces arterial inflow, diminishes washout of the chemotherapeutic agent, and decreases systemic exposure. Despite evidence of some clinical success with TACE, a new type of microspheres with drug-eluting capabilities may offer a precisely controlled and sustainable release of the chemotherapeutic agent into the tumor bed. In animal trials tumor necrosis (approaching 100%) was greatest at 7 days, with significantly lower plasma concentrations of doxorubicin than in control animals treated with doxorubicin intra-arterially. Clinically, drug-eluting microspheres loaded with doxorubicin, either at 75 mg/m2 or at a fixed dose of 150 mg, were used recently and no severe disorders of the hepatic function were observed postprocedure, while a substantial reduction of the fetoprotein levels occurred. An interim analysis of the first 15 patients from the Hong Kong group at 3 months showed an objective response rate of 61.54% and 53.84% according to EASL criteria and RECIST criteria, respectively, and a survival rate of 93.3%. In this paper we present how to use microspheres loaded with doxorubicin and review their clinical value and preliminary performance for treatment of unresectable liver cancer.

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Acknowledgments

Substantial support was provided by preliminary data obtained from R.T. Poon, The University of Hong Kong, Hong Kong, China, in vitro characterization of DC beads published by Lewis et al., and the preclinical assessment in a rabbit model published by K. Hong et al.

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Authors and Affiliations

  1. Division of Angiography and Interventional Radiology, Department of Radiology, Medical University Vienna, General Hospital of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria

    Joachim Kettenbach, Alfred Stadler, Isabella v. Katzler, Rüdiger Schernthaner, Melanie Blum, Johannes Lammer & Thomas Rand

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  1. Joachim Kettenbach
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  2. Alfred Stadler
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  3. Isabella v. Katzler
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Correspondence to Joachim Kettenbach.

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Kettenbach, J., Stadler, A., Katzler, I.v. et al. Drug-Loaded Microspheres for the Treatment of Liver Cancer: Review of Current Results. Cardiovasc Intervent Radiol 31, 468–476 (2008). https://doi.org/10.1007/s00270-007-9280-6

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