Review on endobronchial therapies-current status and future

Area of Science:

• Pulmonology
• Oncology
• Medical Technology

Background:

• Increasing incidence of multifocal lung cancers necessitates lung parenchymal-sparing therapies.
• Lung cancer screening advances detect more early-stage cancers, shifting focus to localized treatments.
• A growing number of patients are ineligible for traditional surgery, driving demand for alternative therapies.

Purpose of the Study:

• To review advancements in transbronchial therapies for localized lung cancer treatment.
• To explore emerging technologies and future applications in minimally invasive lung cancer care.
• To highlight the potential of microwave ablation and novel adjuncts in treating lung tumors.

Main Methods:

• Review of current literature on transbronchial therapies and related technologies.
• Analysis of early and mid-term results for microwave ablation.
• Discussion of adjuncts like robotic bronchoscopy and nanoparticles for improved ablation precision.
• Exploration of emerging energy modalities (steam, pulsed electric field, photodynamic therapy) and intratumoral agents (immunotherapy, gene therapy, CAR T-cells).

Main Results:

• Microwave ablation demonstrates promising early and mid-term outcomes for localized lung cancer.
• Adjunct technologies enhance the precision and efficiency of transbronchial ablation.
• Novel energy sources and intratumoral agents are under intensive investigation.
• Combination therapies with ablation show synergistic abscopal effects in pre-clinical and some clinical studies.

Conclusions:

• Transbronchial therapies, particularly microwave ablation, are evolving as key tools for localized lung cancer treatment.
• Technological advancements and novel therapeutic agents are expanding the possibilities for minimally invasive lung cancer management.
• Future transbronchial approaches may involve combinations of ablation with immunotherapy, gene therapy, and other innovative agents for enhanced efficacy.