Local Chemotherapy Combined with Radiofrequency Ablation for Treatment of Solid Tumors

This project focuses on optimization and efficacy assessment of an image-guided treatment approach utilizing destruction of tissue by heat (delivered in the form of radiofrequency energy) followed by sustained release of chemotherapeutic agents from a polymer matrix. Both the delivery of heat and injection of the drug-polymer construct can be performed percutaneously under image-guidance, and the efficacy of the treatment is evaluated in part by using functional X-ray computed tomography (CT) to study the perfusion of treated lesions. This integration of two progressive yet somewhat controversial techniques – radiofrequency ablation and local drug delivery -- creates a union that highlights the strengths and addresses the shortcomings of both approaches and remains minimally-invasive to the patient. Limited preliminary experiments with this technique have shown promising results in achieving improved tumor control, but have also revealed a number of issues that need to be addressed before this treatment can be used clinically. The focus of the current study is to perfect the approach in preparation for pilot clinical studies. This will be done by achieving three primary goals: 1) Optimizing the delivery of a chemotherapeutic drug to the ablated lesion by comparing two delivery matrixes - solid polymer implants and injectable polymer gels; 2) Developing and refining the image-guided percutaneous approaches of delivering the dual-mode treatment; 3) Methodically determining the long-term efficacy of the integrated treatment in vivo in a rabbit tumor model.

Project PI: Agata Exner, Co-PI: John Haaga, M.D., Department of Radiology, University Hospitals of Cleveland

Experimental liver tumor treated with radiofrequency ablation alone (arrows) or radiofrequency ablation followed by local chemotherapy (arrowhead). Local recurrence of tumor can be seen in the treatment without adjuvant chemotherapy. With chemotherapy, the tumor has been completely controlled.