Prospective Multicentered Safety and Feasibility Pilot for Endobronchial Intratumoral Chemotherapy

Area of Science:

• Pulmonology
• Oncology
• Interventional Pulmonology

Background:

• Malignant airway obstruction (MAO) affects 30% of advanced lung cancer patients, causing severe symptoms.
• Current palliative therapies for MAO are limited, lacking long-term efficacy beyond airway recanalization.

Purpose of the Study:

• To evaluate the safety and feasibility of delivering paclitaxel via local injection into the airway wall.
• To assess the efficacy of this novel treatment for malignant airway obstruction.

Main Methods:

• A multicentered prospective trial involving 23 patients with non-small cell lung cancer and MAO.
• Patients underwent rigid bronchoscopy with recanalization, followed by local airway wall injection of 1.5 mg paclitaxel using a novel microinjection catheter.

Main Results:

• Nineteen patients completed the procedure with successful recanalization and paclitaxel injection.
• No adverse events, severe adverse events, or unanticipated adverse device effects were reported.
• Significant reduction in airway stenosis was observed post-procedure (25%-50% vs. 75%-90%) and maintained at 6 weeks; no further interventions or stenting were required.

Conclusions:

• Local paclitaxel injection is a safe and feasible treatment for malignant airway obstruction in non-small cell lung cancer.
• This novel technique demonstrates promising results in improving airway patency and reducing stenosis.