A novel in situ permeation system and its utility in cancer tissue ablation

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Abstract

Focal ablation therapy is an emerging treatment modality for localized cancer lesions. It is an attractive strategy for inhibiting tumor progression and preventing morbidity associated with open surgery. As for intratissue drug delivery systems for use in local therapy, the convection-enhanced delivery (CED) of liquid drugs has been utilized, particularly for the treatment of malignant brain tumors. Although the conventional CED system is useful for providing drug/vehiclebased local therapy, there are several reported disadvantages in terms of the ability to control the extent of drug diffusion. We herein developed and validated a novel in situ permeation (ISP)-MW-1 system for achieving intratissue drug diffusion. The ISP system includes a perfusion catheter connected to an injector and aspirator, which enables intratissue perfusion of the solute diluted in the vehicle in the tip-inserted cavity. We subsequently evaluated the utility of the ISP-MW-1 system for in situ permeation in a subcutaneous tumor model in hamsters. Dehydrated ethanol, saline and 50% acetic acid were evaluated as the vehicle, and methylene blue was used as a dissolved substance for evaluating the diffusion of the agent. As a result, almost all of the tumor tissue within the capsule (tumor size: ∼3 cm) was permeated with the dehydrated ethanol and 50% acetic acid and partially with the saline. We further demonstrated that ISP treatment with 50% acetic acid completely ablated the subcutaneous tumors in all of the treated hamsters (n=3). Therefore, the ISP-MW-1 system is a promising approach for controlling the intratissue diffusion of therapeutic agents and for providing local ablation therapy for cancer lesions. We believe that this system may be applicable to a broad range of medicinal and industrial fields, such as regenerative medicine, drug delivery systems, biochemistry and material technologies as well as cancer therapy.

Figures

  • Figure 1. (A) Schematic figure showing the principle of the ISP-MW-1 system and conventional CED system-based intratissue drug delivery. Both systems are used to achieve the local diffusion and distribution of medical agents. The flow of the infused agent is indicated by red or blue arrows. In the ISP-MW-1 system, another inflow channel is optionally added for the air inflow (explained in Fig. 3C) or infusion of a second agent. (B) The image of the perfusion catheter used in
  • Figure 2. (A) The image of the subcutaneous tumors in the same hamster as in Fig. 1C immediately prior to (upper panel) and after (lower panel) resection. A total 60 min of perfusion with the ISP-MW-1 system was performed, and then both tumors were resected. Images of tumor sections indicating the full distribution of the agent are shown in the lower panel. The red arrow indicates the direction of insertion of the perfusion catheter. (b) Histological appearance of the untreated subcutaneous tumor. The sections were stained with hematoxylin and eosin. (C) The subcutaneous tumor was treated with saline (methylene blue was dissolved as a dye) for 3 h with the ISP-MW-1 system and then resected. Images of tumor sections indicating partial diffusion of the agent are shown. The red arrow indicates the direction of insertion of the perfusion catheter.
  • Figure 3. (A) The image of the subcutaneous tumor during treatment with 50% acetic acid (methylene blue was dissolved as a dye) using the ISP-MW-1 system.
  • Figure 4. (A) The utility of the ISP-MW-1 system for achieving cancer ablation was evaluated in the bilateral subcutaneous tumor model in hamsters. The right tumor was treated with 50% acetic acid (methylene blue was dissolved as a dye) using the ISP-MW-1 system. In the left tumor, the perfusion catheter was temporarily inserted as a sham operation. The images of the subcutaneous tumors before treatment, at 20 min of ISP treatment and on day 7 after ISP treatment are shown. A total 20 min of perfusion of the agent was performed in the right tumor. The arrowhead indicates the scar without any residual cancer tissue. (b) The antitumor effects of the local therapy were evaluated using three tumor-bearing hamsters. An image of the treatment course in one of the hamsters is shown in (A). The length of the tip of the perfusion catheter and total time for perfusion with acetic acid using the ISP-MW-1 system were altered in reference to the tumor size prior to treatment. All hamsters were examined for the tumor size on day 7 after ISP with the agent. The untreated tumors were also monitored as a negative control. The graph indicates the tumor volume on the treated and untreated sides. On the treated side, all tumors completely disappeared following chemical ablation with ISP-MW-1 (upper panel). In contrast, the tumor volume rapidly increased on the untreated side (lower panel).
  • Figure 5. Using the ISP-MW-1 system, the intratissue pressure in the tipinserted cavity can be changed between positive and negative. In the positive pressure mode, the mechanism of in situ permeation is similar to that observed in the CED system. Under the perfusion with ISP-MW-1 system, the degree of intratissue diffusion is dependent on the convection due to the effects of the positive pressure and the drug/vehicle diffusivity. When keeping the cavity pressure periodically negative, the focal diffusion of the infused agents is more controllable. Additionally, when maintaining negative pressure with the ISP-MW-1 system, the tissue-intrinsic fluid can be aspirated and removed with the infused agent through the tissue-catheter tip interface.

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CITATION STYLE

APA

Watanabe, M. (2015). A novel in situ permeation system and its utility in cancer tissue ablation. International Journal of Oncology, 47(3), 875–883. https://doi.org/10.3892/ijo.2015.3068

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