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评估新型可生物吸收聚合物载药微球在犬肝细胞肿瘤经动脉栓塞中的应用。

Evaluation of the use of a novel bioabsorbable polymer drug-eluting microsphere for transarterial embolization of hepatocellular neoplasia in dogs.

机构信息

Department of Veterinary Surgical and Radiological Sciences, University of California-Davis, School of Veterinary Medicine, Davis, California, United States of America.

Boston Scientific Corporation, Marlborough, Massachusetts, United States of America.

出版信息

PLoS One. 2022 Aug 8;17(8):e0269941. doi: 10.1371/journal.pone.0269941. eCollection 2022.

Abstract

In dogs with non-resectable hepatic neoplasia, treatment options are limited. The objectives of this study were to describe the use of a novel drug-eluting embolic microsphere containing paclitaxel for use during transarterial chemoembolization (TACE), to compare results of liver-specific owner questionnaires and tumor volume pre- and post-TACE, and to measure systemic paclitaxel concentration post-TACE. Client-owned dogs with non-resectable hepatic neoplasia were prospectively enrolled. All owners completed questionnaires validated for the assessment of subjective outcomes in dogs with cancer before the TACE procedure and approximately 4 weeks after the TACE procedure. A CT scan was performed before TACE and 1 month after TACE; results were compared. Blood samples were obtained at specified time points post-TACE to determine systemic paclitaxel concentrations. Seven dogs (median weight: 8.9 kg; range, 4.3-31 kg) were enrolled. TACE was successfully performed in all dogs, and no intra-procedural complications were encountered. Questionnaire scores improved significantly post-TACE. Among the 6 dogs for which full data were available, median pre-TACE tumor volume was 390 cc (range 152-1,484; interquartile range 231-1,139) and median post-TACE tumor volume was 203 cc (range 98-889; interquartile range 151-369), which was significantly (P = .028) lower. All 6 dogs had a reduction in volume at the post-TACE measurement. Mean percent change in tumor volume was -45.6% (95%CI -58.6 to -32.6%). The mean plasma paclitaxel concentration in canine blood peaked at 4 days post-TACE procedure and was 25.7 ng/mL (range = 3.09-110 ng/mL) Median survival time was 629 days (95%CI 18 to upper limit not reached). The use of a novel paclitaxel-eluting microsphere in this cohort of dogs successfully decreased tumor volume significantly after TACE and improved clinical signs. Future investigation into the use of TACE and other similar therapies is warranted due to the promising outcomes noted in this cohort.

摘要

在患有不可切除肝肿瘤的犬中,治疗选择有限。本研究的目的是描述使用一种新型载紫杉醇的药物洗脱微球在经动脉化疗栓塞术(TACE)中的应用,比较 TACE 前后肝特异性主人问卷和肿瘤体积的结果,并测量 TACE 后系统内紫杉醇浓度。前瞻性纳入患有不可切除肝肿瘤的患犬。所有主人在 TACE 程序前和 TACE 程序后大约 4 周完成了用于评估癌症犬主观结果的验证问卷。在 TACE 前和 TACE 后 1 个月进行 CT 扫描;结果进行了比较。在 TACE 后特定时间点采集血样以确定系统内紫杉醇浓度。7 只犬(中位数体重:8.9kg;范围,4.3-31kg)入组。所有犬均成功进行 TACE,且无术中并发症。TACE 后问卷评分显著提高。在 6 只提供完整数据的犬中,中位数 TACE 前肿瘤体积为 390cc(范围 152-1484;四分位间距 231-1139),中位数 TACE 后肿瘤体积为 203cc(范围 98-889;四分位间距 151-369),显著降低(P=0.028)。所有 6 只犬在 TACE 后测量时肿瘤体积均减小。肿瘤体积的平均百分比变化为-45.6%(95%CI -58.6 至 -32.6%)。犬血中紫杉醇的平均血浆浓度在 TACE 术后 4 天达到峰值,为 25.7ng/mL(范围=3.09-110ng/mL)。中位生存时间为 629 天(95%CI 18 至无上限)。在该犬组中使用新型载紫杉醇微球成功地在 TACE 后显著减少肿瘤体积并改善临床症状。由于该队列中观察到的有希望的结果,需要进一步研究 TACE 和其他类似治疗方法的应用。

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