A study presented at the Society of Interventional Radiology’s 37th Annual Scientific Meeting in San Francisco, Calif. shows that percutaneous cryoablation may be provide another treatment alternative for people suffering from metastatic breast cancer, in whom the disease has progressed to other areas of the body. According to the researchers, percutaneous cryoablation therapy could be the last in the line of treatments to stop individual spots of remaining metastases by freezing and destroying tumors.

Peter J. Littrup, M.D., director of imaging core and radiology research at the Karmanos Cancer Institute in Detroit, Mich says:

“Breast cancer is the most common cancer in women, causing 1 million new cases and killing 370,000 people worldwide each year, and approximately 10,000 to 15,000 cases of stage IV breast cancer occur in the United States annually.

If you envision cancer treatment as a three-legged stool: you have radiation therapy, surgery and chemotherapy. When you get to the point of metastatic disease, you end up managing people whose treatments have failed. We are introducing the fourth leg on the stool of cancer care: tumor ablation.”

Littrup explains:

“Stage IV metastatic breast cancer means tumors have spread widely from the primary tumors in the breasts to other tissues of the body. This stage of disease is currently viewed as incurable and associated with a low rate of survival. While less than 5 percent of those are initially diagnosed with metastases, an estimated 25 to 40 percent will develop these additional tumors, which are notoriously difficult to wipe out, even with multiple forms and repeated rounds of treatment.

At this point, treatments are considered palliative – with the intent to keep metastases at bay while hopefully providing individuals more time and improved quality of life, rather than a complete cure. But after mastectomy, radiation and chemotherapy, it is time to try something new.”

Littrup says :

“Why should people have to keep changing from one expensive chemo drug to another when there are just a few remaining spots? Cryoablation could offer these individuals a new treatment option.”

The metastatic tumors are usually found in the liver, the lungs, kidneys, bones and in soft tissues, as well as in the pleura, a thin layer of tissue that wraps around the lungs.

The procedure essentially removes single tumors that persist after the first and follow-up treatment. Percutaneous cryoablation is an interventional radiology procedure whereby tiny probes are inserted into small cuts in the skin via catheter and then guided to the tumors where pressurized argon gas is introduced, which turns the tumor into ice, hence effectively killing the cancerous tissue before Helium gas is pumped in to help release the needle guided by computed tomography (CT) or ultrasound.

The procedure is captured by medical imaging to identify distinct densities between the normal and frozen cancer tissue, so that the ice ball, which has a lower density in comparison with the surrounding tissue, can be seen as a clearly defined darker mass.

Because of the minimal damage to surrounding healthy tissues, the dramatically lower side effects and recovery times in comparison with other therapies, the treatment could be a valuable alternative to other spot-therapies, according to Littrup.

He continued saying:

“Cryoablation as a targeted therapy is beneficial because it can significantly reduce discomfort and incidence of disease. It’s a much better option, we think, than surgery, especially since many metastatic patients are not candidates for surgery, and it may potentially lead to longer survival if it coincides with more data concerning primary metastases in other regions of the body.”

The researchers performed the percutaneous cryoablation procedure guided with CT, ultrasound or a combination of both methods in a total of eight people who had nine tumors. Of the eight patients, six had previously undergone at least a single mastectomy prior to the therapy and their secondary tumors were in the patients’ kidney, liver and lung.

All procedures were successful and the researchers reported no serious complications. They identified all individual tumors that remained in the body and noted that there was no recurrence of the local cancer. The patients’ average overall survival was 46 months, with 25% of patients surviving past their five-year anniversary of treatment.

In conclusion, the researchers say that percutaneous cryoablation could potentially offer an effective alternative therapy for metastatic breast cancer, particularly in view of many more patients suffering from other types of metastatic disease who showed promising results.

Littrup concludes:

“This therapy provides a minimal rate of cancer recurrence and no major complications, making these ice balls ideal for targeting metastatic tumors that are limited in number and location. This is preliminary study, and at this point we’re hoping that the evidence could be a stepping-stone for a bigger study to look at more patients. If we can get more data that supports percutaneous cryoablation for metastatic breast cancer, it could be a huge finding.”

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Written by Petra Rattue