Intratumoral cisplatin/epinephrine-injectable gel as a palliative treatment for accessible solid tumors: a
H A Burris1, C L Vogel, D Castro
1Brooke Army Medical Center, Fort Sam Houston, Texas, USA.
Summary
Intratumoral injections of cisplatin/epinephrine-injectable gel showed a 50% objective tumor response rate in patients with accessible solid tumors. This local chemotherapy approach demonstrated promising results with no dose-limiting toxicities, warranting further clinical trials.
Area of Science:
- Oncology
- Pharmacology
- Biomedical Engineering
Background:
- Malignant tumors of various histologic types often present treatment challenges, especially in patients ineligible for surgery, radiation, or systemic chemotherapy.
- Accessible solid tumors on the skin, subcutaneous tissue, head, neck, trunk, tongue, oral pharynx, and esophagus require innovative therapeutic strategies.
- Local chemotherapy offers a targeted approach to deliver cytotoxic agents directly to the tumor site, potentially minimizing systemic side effects.
Purpose of the Study:
- To evaluate the safety and efficacy of intratumoral injections of cisplatin/epinephrine-injectable gel in patients with advanced, accessible solid tumors.
- To determine the objective tumor response rate and duration of response following local chemotherapy.
- To assess the occurrence of cisplatin-related toxicities in the context of intratumoral administration.
Main Methods:
- A prospective study involving 45 patients with 82 evaluable malignant tumors.
- Weekly intratumoral injections of cisplatin/epinephrine-injectable gel for 4 weeks.
- Dose escalation of cisplatin from 1 mg/cm³ to 6 mg/cm³ based on observed toxicities; tumor response assessed at 2, 4, 8, and 12 weeks post-injection.
Main Results:
- An overall objective tumor response rate of 50% (41/82 tumors) was observed.
- Complete response rates were 40% (33/82 tumors), with a median response duration of 160 days.
- Complete responses were higher for adenocarcinoma (58%) and squamous cell carcinoma (38%); no dose-limiting cisplatin-related toxicities (nephrotoxicity, neurotoxicity, ototoxicity) were reported.
Conclusions:
- Intratumoral cisplatin/epinephrine-injectable gel demonstrates significant efficacy and a favorable safety profile for palliative treatment of accessible solid tumors.
- Local chemotherapy with this formulation offers a viable treatment option for patients with limited therapeutic alternatives.
- Further clinical trials are warranted to confirm these findings and explore the broader application of this localized chemotherapy approach.
