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Advances in ablation
For individuals with hepatocellular carcinoma, percutaneous locoregional therapies can extend the time to liver transplantation. Albadawi et al. developed an ionic liquid–ablative agent named LATTE that could be locally injected into rat, rabbit, and pig livers in vivo under imaging guidance. LATTE coformulated with the chemotherapy drug doxorubicin injected into tumors in rat and rabbit livers ablated the desired regions, uniformly distributed the drug, and could also ablate human liver tumor tissue samples ex vivo. Results support the use of LATTE for percutaneous ablation of solid tumors.
Abstract
Percutaneous locoregional therapies (LRTs), such as thermal ablation, are performed to limit the progression of hepatocellular carcinoma (HCC) and offer a bridge for patients waiting for liver transplantation. However, physiological challenges related to tumor location, size, and existence of multiple lesions as well as safety concerns related to potential thermal injury to adjacent tissues may preclude the use of thermal ablation or lead to its failure. Here, we showed a successful injection of an ionic liquid into tissue under image guidance, ablation of tumors in response to the injected ionic liquid, and persistence (28 days) of coinjected chemotherapy with the ionic liquid in the ablation zone. In a rat HCC model, the rabbit VX2 liver tumor model, and 12 human resected tumors, injection of the ionic liquid led to consistent tumor ablation. Combining the ionic liquid with the chemotherapy agent, doxorubicin, resulted in synergistic cytotoxicity when tested with cultured HCC cells and uniform drug distribution throughout the ablation zone when percutaneously injected into liver tumors in the rabbit liver tumor model. Because this ionic liquid preparation is simple to use, is efficacious, and has a low cost, we propose that this new LRT may bridge more patients to liver transplantation.
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