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Magnetic nanoparticles and drug targeting: development, current use, and future roles in interventional oncology practice
JVIR
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Posters and Exhibits
Educational Exhibit
S247
Abstract No. 559
Hepatitis C virus and interventional radiology: the role of newer anti-viral therapies and how they will impact future IR practice A. Baadh1, A. Singh2, P. Malet3, J. Hoffmann4; 1WinthropUniversity Hospital, New York, NY; 2New York College of Osteopathic Medicine, Old Westbury, NY; 3WinthropUniversity Hospital, Mineola, NY; 4WInthrop-University Hospital, Garden City, NY Learning Objectives: To review the newer medications used to treat Hepatitis C Virus (HCV), and predict how their success will impact oncology practice over the next 10 years. Background: Hepatitis C Virus (HCV) is a cause of significant morbidity and mortality in the United States (US), but treatment regimens have improved in recent years. As HCV is a major cause of cirrhosis and hepatocellular carcinoma (HCC) in the US, it is prudent for interventional radiologists to be familiar with treatment options and how better control and treatment of HCV will likely impact IR/IO practice. A number of newer medications are now used in the US to treat HCV, which can lead to lower rates of HCC and potentially fewer HCC-related procedures in interventional radiology. Clinical Findings/Procedure Details: We review important factors about HCV that are crucial for interventional radiologists, such as etiology, association with HCC, and current role of antiviral medications to treat HCV. Further, we describe trends in new HCV cases reported in the United States and review the relevant literature, while also comparing this to sales of newer antiviral medications used to treat HCV. The trends are then used to extrapolate HCV-related cirrhosis and new HCC cases in the US over the coming 5-10 years. This will provide interventional radiologists with projections as to how these medications will alter IR/IO practice over the next decade, including the impact/potential decrease in number of HCC cases diagnosed in the US, thus leading to changes in ablation and embolization volumes. Conclusions: Newer oral medications now used in the US to treat HCV will likely result in a substantial decrease in incidence of HCC and thus the number of interventional oncology procedures needed to treat these patients.
Educational Exhibit
Abstract No. 560
Sorafenib in combination with transarterial therapies for hepatocellular carcinoma: is more always better?
Learning Objectives: 1. To provide a brief update on the combination therapy of Sorafenib with either transarterial chemoembolization (TACE) or radioembolization (TARE) in advanced Hepatocellular Carcinoma (HCC). 2. To discuss the efficacy in particular of such combination therapies in the management of advanced HCC.
Educational Exhibit
Abstract No. 561
Transradial access in interventional oncology— advantages, tips, pitfalls, and complications E. Lopez1, R. Liu1, E. Balesh1, K. Yamada2, z. Irani1; 1 Massachusetts General Hospital, Boston, MA; 2Atlanta, GA Learning Objectives: 1) Review the technique of transradial arterial access (TRAA), including currently available equipment 2) Describe advantages/disadvantages of TRAA for intra-arterial liver-directed therapies (Y90, TACE) 3) Depict technical pitfalls and pearls associated with TRAA for liver-directed therapies, including attention to patient positioning, room setup and intraprocedural cone beam CT. Background: TRAA is a mature, primary access for coronary angiography and intervention. However, TRAA has only recently been adopted by interventional oncologists for intraarterial liver-directed therapies. Reasons for slow adoption of TRAA in interventional radiology include operator and support staff inexperience, and unfamiliarity and equipment limitations.
Posters and Exhibits
A. Khankan1, N. Guzaiz2, A. Al-Olayan2, T. Al-Hazmi3, D. Valenti4, M. Al-Moaiqel2; 1King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2King Abdulaziz Medical City, Riyadh; 3Umm Al-Qura University, Makkah; 4McGill University Health Center, Montreal, QC
Background: Sorafenib is approved as the first and only molecularly targeted therapy for advanced unresectable HCC based on results from the phase III Sorafenib HCC Assessment Randomized Protocol (SHARP) clinical trial. It has been proven that Sorafenib prolongs overall survival (OS) and prolongs the time-to-progression (TTP) in patients with advanced HCC who are not candidates to other therapies. However in the SHARP study, about 50% of patients did receive some form of local therapy prior to treatment with sorafenib. Although combining sorafenib with either TACE or TARE is still considered in special populations or clinical trials, several trials have been demonstrated promising synergistic or additive efficacy compare to the current standard of sorafenib monotherapy. Clinical Findings/Procedure Details: The poster will summarize the most current status of sorafenib in combination with transarterial hepatic therapies with focusing on 1. Rationale for combining sorafenib with TACE or TARE. 2. Sequence of administration, efficacy and safety of such combination therapies. 3. Recent pivotal studies related to the efficacy of sorafenib in combination with TACE or TARE in advanced HCC. 4. Unresolved issues and possible future directions. Conclusions: Although most available data are heterogeneous, the combination of sorafenib with either TACE or TARE is safe and well-tolerated regardless of the sequence of administration. Such combinations do not showed significant improvement in OS with either transarterial therapies. However, combining sorafenib with TACE shows clinical benefit as it improves TTP and overall response rate compare to TACE alone, while combining sorafenib with TARE does not show significant clinical benefits yet due to the lack of studies. Many questions are still to be answered regarding optimal timing, dosing, and sequence of sorafenib administration in addition to the optimal agents and techniques used in TACE and TARE.
’
Posters and Exhibits
Educational Exhibit
S247
Abstract No. 559
Hepatitis C virus and interventional radiology: the role of newer anti-viral therapies and how they will impact future IR practice A. Baadh1, A. Singh2, P. Malet3, J. Hoffmann4; 1WinthropUniversity Hospital, New York, NY; 2New York College of Osteopathic Medicine, Old Westbury, NY; 3WinthropUniversity Hospital, Mineola, NY; 4WInthrop-University Hospital, Garden City, NY Learning Objectives: To review the newer medications used to treat Hepatitis C Virus (HCV), and predict how their success will impact oncology practice over the next 10 years. Background: Hepatitis C Virus (HCV) is a cause of significant morbidity and mortality in the United States (US), but treatment regimens have improved in recent years. As HCV is a major cause of cirrhosis and hepatocellular carcinoma (HCC) in the US, it is prudent for interventional radiologists to be familiar with treatment options and how better control and treatment of HCV will likely impact IR/IO practice. A number of newer medications are now used in the US to treat HCV, which can lead to lower rates of HCC and potentially fewer HCC-related procedures in interventional radiology. Clinical Findings/Procedure Details: We review important factors about HCV that are crucial for interventional radiologists, such as etiology, association with HCC, and current role of antiviral medications to treat HCV. Further, we describe trends in new HCV cases reported in the United States and review the relevant literature, while also comparing this to sales of newer antiviral medications used to treat HCV. The trends are then used to extrapolate HCV-related cirrhosis and new HCC cases in the US over the coming 5-10 years. This will provide interventional radiologists with projections as to how these medications will alter IR/IO practice over the next decade, including the impact/potential decrease in number of HCC cases diagnosed in the US, thus leading to changes in ablation and embolization volumes. Conclusions: Newer oral medications now used in the US to treat HCV will likely result in a substantial decrease in incidence of HCC and thus the number of interventional oncology procedures needed to treat these patients.
Educational Exhibit
Abstract No. 560
Sorafenib in combination with transarterial therapies for hepatocellular carcinoma: is more always better?
Learning Objectives: 1. To provide a brief update on the combination therapy of Sorafenib with either transarterial chemoembolization (TACE) or radioembolization (TARE) in advanced Hepatocellular Carcinoma (HCC). 2. To discuss the efficacy in particular of such combination therapies in the management of advanced HCC.
Educational Exhibit
Abstract No. 561
Transradial access in interventional oncology— advantages, tips, pitfalls, and complications E. Lopez1, R. Liu1, E. Balesh1, K. Yamada2, z. Irani1; 1 Massachusetts General Hospital, Boston, MA; 2Atlanta, GA Learning Objectives: 1) Review the technique of transradial arterial access (TRAA), including currently available equipment 2) Describe advantages/disadvantages of TRAA for intra-arterial liver-directed therapies (Y90, TACE) 3) Depict technical pitfalls and pearls associated with TRAA for liver-directed therapies, including attention to patient positioning, room setup and intraprocedural cone beam CT. Background: TRAA is a mature, primary access for coronary angiography and intervention. However, TRAA has only recently been adopted by interventional oncologists for intraarterial liver-directed therapies. Reasons for slow adoption of TRAA in interventional radiology include operator and support staff inexperience, and unfamiliarity and equipment limitations.
Posters and Exhibits
A. Khankan1, N. Guzaiz2, A. Al-Olayan2, T. Al-Hazmi3, D. Valenti4, M. Al-Moaiqel2; 1King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2King Abdulaziz Medical City, Riyadh; 3Umm Al-Qura University, Makkah; 4McGill University Health Center, Montreal, QC
Background: Sorafenib is approved as the first and only molecularly targeted therapy for advanced unresectable HCC based on results from the phase III Sorafenib HCC Assessment Randomized Protocol (SHARP) clinical trial. It has been proven that Sorafenib prolongs overall survival (OS) and prolongs the time-to-progression (TTP) in patients with advanced HCC who are not candidates to other therapies. However in the SHARP study, about 50% of patients did receive some form of local therapy prior to treatment with sorafenib. Although combining sorafenib with either TACE or TARE is still considered in special populations or clinical trials, several trials have been demonstrated promising synergistic or additive efficacy compare to the current standard of sorafenib monotherapy. Clinical Findings/Procedure Details: The poster will summarize the most current status of sorafenib in combination with transarterial hepatic therapies with focusing on 1. Rationale for combining sorafenib with TACE or TARE. 2. Sequence of administration, efficacy and safety of such combination therapies. 3. Recent pivotal studies related to the efficacy of sorafenib in combination with TACE or TARE in advanced HCC. 4. Unresolved issues and possible future directions. Conclusions: Although most available data are heterogeneous, the combination of sorafenib with either TACE or TARE is safe and well-tolerated regardless of the sequence of administration. Such combinations do not showed significant improvement in OS with either transarterial therapies. However, combining sorafenib with TACE shows clinical benefit as it improves TTP and overall response rate compare to TACE alone, while combining sorafenib with TARE does not show significant clinical benefits yet due to the lack of studies. Many questions are still to be answered regarding optimal timing, dosing, and sequence of sorafenib administration in addition to the optimal agents and techniques used in TACE and TARE.