Related Experiment Videos
Tumor-targeted chemotherapy with lipid contrast medium and macromolecular anticancer drug (SMANCS) for renal cell
M Kobayashi1, K Imai, S Sugihara
1Department of Urology, Gunma University School of Medicine, Japan.
Abstract:
Twenty-five patients with renal cell carcinoma were treated with a lipophilic macromolecular drug, poly(stylene-co-maleic acid)-conjugated neocarzinostatin (SMANCS) dissolved in lipid contrast medium (Lipiodol). The drug was injected by catheterizing the renal artery and another feeding artery in 24 patients, and in the common hepatic artery in 1 patient with metastases to the liver after a radical nephrectomy. The procedure of selective arterial administration of 3-20 mg/mL of SMANCS/Lipiodol was simple to perform and was required once every two to three weeks. Total dose of SMANCS for each patient varied from 3 to 57 mg. Both SMANCS and Lipiodol accumulated more selectively in tumor than in any other tissue and remained in the neovasculature and extracapillary space for a long time. CT pattern of the remaining oil contrast medium in the tumor was characterized by the high-density area localized mainly in the periphery of the tumor around the central necrosis. When hyperviscosity Lipiodol (Lipiodol HV) was used as lipid contrast medium, it remained more persistently in the tumor and disappeared more slowly than Lipiodol. Moreover, the pronounced anticancer effect was recognized when SMANCS/Lipiodol HV was administered compared with only SMANCS/Lipiodol. Severe side effects, such as myelosuppression, unendurable pain, paralytic ileus, etc., were not observed. This targeting chemotherapy may be of great significance for advanced renal cell carcinoma.
Insights
Targeted chemotherapy using poly(styrene-co-maleic acid)-conjugated neocarzinostatin (SMANCS) in Lipiodol demonstrated significant anticancer effects in renal cell carcinoma patients. This method showed selective tumor accumulation and minimal severe side effects, offering promise for advanced cases.
Area of Science:
- Oncology
- Pharmacology
- Radiology
Background:
- Renal cell carcinoma (RCC) presents treatment challenges, especially in advanced stages.
- Effective and targeted drug delivery systems are crucial for improving therapeutic outcomes.
- Lipid-based contrast media offer potential for localized drug retention and enhanced efficacy.
Purpose of the Study:
- To evaluate the efficacy and safety of SMANCS/Lipiodol targeted chemotherapy for renal cell carcinoma.
- To assess the tumor accumulation and retention characteristics of SMANCS/Lipiodol.
- To compare the effects of standard Lipiodol versus hyperviscosity Lipiodol (Lipiodol HV) in this treatment regimen.
Main Methods:
- Selective arterial administration of SMANCS dissolved in Lipiodol or Lipiodol HV to 25 RCC patients.
- Catheterization of renal or hepatic arteries for drug delivery.
- CT imaging to monitor contrast medium distribution and tumor response.
- Dosage and frequency adjusted based on patient response and tolerance.
Main Results:
- SMANCS and Lipiodol showed selective accumulation in tumor tissues, persisting longer in the tumor periphery.
- Lipiodol HV demonstrated more persistent retention and slower clearance compared to standard Lipiodol.
- A pronounced anticancer effect was observed with SMANCS/Lipiodol HV administration.
- No severe side effects like myelosuppression or paralytic ileus were reported.
Conclusions:
- Targeted intra-arterial chemotherapy with SMANCS/Lipiodol is a feasible and effective treatment for advanced RCC.
- Lipiodol HV enhances drug retention and anticancer efficacy compared to standard Lipiodol.
- This approach offers a promising, well-tolerated therapeutic strategy for advanced renal cell carcinoma.