[Pulmonary artery chemoembolization--from bench to bedside].

Area of Science:

• Interventional Radiology
• Medical Oncology
• Pulmonary Medicine

Context:

• Locoregional therapies for inoperable lung metastases are limited, with isolated lung perfusion (ILP) being the primary option.
• ILP demonstrates feasibility and oncological response but is rarely used clinically due to its invasiveness.

Purpose:

• To evaluate the efficacy and safety of a novel lung chemoembolization technique in preclinical and clinical settings.
• To compare chemoembolization with isolated lung perfusion and intravenous chemotherapy for lung metastases.

Summary:

• Lung chemoembolization involves simultaneous injection of degradable starch microspheres and carboplatin into the pulmonary artery, achieving temporary reversible embolization.
• In a solitary lung metastasis model, chemoembolization was superior to intravenous chemotherapy and comparable to ILP, with no early toxicity.
• The procedure uses only one-third of the standard intravenous cytostatic dose, minimizing systemic side effects.
• Large-animal models showed the technique is feasible via pulmonary catheter without significant circulatory changes, and no chronic injury was observed after six months.
• Initial clinical applications in patients with unresectable metastases indicate the procedure is well-tolerated.

Impact:

• Lung chemoembolization presents a promising, less invasive, and effective locoregional treatment option for unresectable lung metastases.
• This approach may improve patient outcomes by offering a viable alternative to more invasive procedures or systemic therapies with significant side effects.