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The primary purpose of Trans-Arterial Chemoembolization (TACE) is to restrict blood supply to hyper vascularized tumors
whilst delivering a chemotherapeutic drug in a localized, consistent and efficacious regimen. Clinical opinion is divided
regarding the primary mode of action. Physical embolic or controlled drug release. Both the use of ethiodized oil emulsions
mixed with doxorubicin (conventional cTACE) and ionically loaded Drug-Eluting Beads (DEB-TACE) provide proven clinical
efficacy. Recent developments in emulsion stabilization have posed the question of whether the safety of reduced systemic
drug exposure provided by DEB could be combined with oil emulsions to provide a therapeutic benefit in patients. In a study
conducted by Takayasu et al., n=11030 patients treated with oil emulsions vs emulsions and particulates presented an overall
survival benefit in the particulate combination therapy. This study evaluates novel radiopaque DEB in combination with oil
emulsions using in vitro-in vivo flow distribution, drug release profiles and physiochemical stability. Bead stabilized emulsions
were easily prepared and doxorubicin loading into the DEB was rapid. In vitro DEB emulsions exhibited enhanced physical
embolic abilities with slower drug elution kinetics vs c-TACE. In vivo VX2 tumor model confirmed low systemic doxorubicin,
anti-tumor activity and CT imaging at 7 days clearly showed oil droplets remaining throughout the liver lobe and targeted
arteries filled with radiopaque beads. Fluoroscopy in a porcine hepatic arterial and in vitro vascular flow model indicated
comparable flow characteristics during administration to that of c-TACE.
Biography
Marcus Caine is an Innovation Scientist at BTG. Initially focusing on analytical method development and validation, he is pursuing part-time PhD with the University of Southampton in Applied Biomimetic Microfluidics and focusing on the application of the project for advancing treatment in the field of interventional oncology and pulmonology.