Transcatheter arterial infusion of anti-programmed cell death 1 antibody pembrolizumab combined with temozolomide or nab-paclitaxel in patient with primary anorectal malignant melanoma: Four case reports

Primary anorectal malignant melanoma (ARMM) is an extremely rare but aggressive tumor. We assessed the efficacy and safety of transcatheter arterial infusion (TAI) with anti-PD-1 antibody pembrolizumab at a dosage of 100 mg with 0.9% NaCl at a volume of 100 mL administered over a 30-min period every 3 weeks, combined with temozolomide or albumin-bound paclitaxel (nab-paclitaxel) in four patients with ARMM. Temozolomide was administered orally once per day at a dosage of 200 mg/m2/d for five consecutive days about every 4 weeks. Nab-paclitaxel was administered at a dosage of 200mg/m2/d once about every 3 weeks. Among four patients with a median follow-up of 8.9 months, two cases showed Murine Double Minute 2 (MDM2) amplification. Case 1 with Stage II ARMM showed pathological complete response after four cycles of TAI with pembrolizumab combined with nab-paclitaxel. Case 4 was at Stage II and showed stable disease consistently throughout the treatment. Case 2 was at stage II and Case 3 was at stage III, and they showed partial response after four or three cycles, respectively, of TAI with pembrolizumab combined with temozolomide. No Grades 3–4 adverse reactions were observed. Therefore, a combination of TAI with pembrolizumab and temozolomide or with nab-paclitaxel appears to be a promising option for treating ARMM. However, multicenter clinical trials are required to confirm the efficacy and safety of this procedure

The application of pre-filled SS-Y valve fixation in patients undergoing transcatheter arterial infusion chemotherapy / 中国实用护理杂志

Objective@#To improve the problems of catheter occlusion, low comfort of patients and low satisfaction of nurses, the pre-filled SS-Y valve fixation method was used for catheter nursing.@*Methods@#Traditional method of arterial catheter nursing were performed in 54 patients with malignant tumors of digestive tract treated by transcatheter arterial infusion chemotherapy (TAI) (control group) from April 1 to December 31, 2017 in the Department of Radiation Intervention, the Affiliated Second Hospital of Medical College of Zhejiang University. Pre-filled SS-Y valve fixation method was used for arterial catheter nursing in 72 patients treated with TAI (observation group) from January 1 to September 30, 2018. The fixation, comfort and satisfaction of nurses were compared between the two groups.@*Results@#The rate of arterial catheter displacement, slippage and satisfaction of nurses were 0, 0 and 97.22% (70/72) in observation group, and 13.0% (7/54), 5.6% (3/54), 77.78% (42/54) in control group. Significant statistic differences were found between two groups in rate of arterial catheter displacement and comfort scores (χ2=9.882, 11.813, P<0.01). There was no significant difference in slippage between the two groups (P>0.05). The comfort scores of the patients in observation group at 5 time points were better than those in control group, and the difference was statistically significant (Z=-6.462--3.611, P < 0.01).@*Conclusions@#The method of pre-filled SS-Y valve fixation is reliable with a low displacement rate and a higher satisfaction for both patients and nurses. This method can be popularized in clinical nursing.

Transcatheter arterial infusion chemotherapy followed by surgery in patients with unresectable stage III non-small cell lung cancer / 肿瘤

Objective: To evaluate the clinical response, adverse reactions and prognosis of transcatheter arterial infusion (TAI) chemotherapy followed by surgery in patients with unresectable stage III non-small cell lung cancer (NSCLC). Methods: A retrospective study was performed in 81 patients with unresectable stage III NSCLC. All patients received 2 cycles of TAI chemotherapy. Surgical treatment was performed for patients with partial response or patients with stable disease and tumor reduction. The primary endpoint was overall survival (OS) and the secondary endpoints were disease control rate (DCR) and adverse reactions. Results: The results of response evaluation after 2 cycles of TAI chemotherapy were partial response in 40 patients (49.4%), stable disease in 30 patients (37.0%) and disease progression in 11 patients (13.6%); the DCR was 86.4% (70/81). The main adverse reactions were graded as I-II. In 55 patients undergoing TAI chemotherapy, the surgical resection rate was 94.5% (52/55), and the postoperative complication rate was 32.7% (18/55); the 1-, 2- and 3-year survival rates were 78.2%, 52.7% and 34.5%, respectively. The subgroup analysis showed that the OS of the patients with partial response was significantly better than that of the patients with stable disease; the median survival time were 37.0 and 21.0 months, respectively (P = 0.01 9). The median survival time (34.0 months) of the patients diagnosed of squamous cell carcinoma was longer than that of the patients diagnosed of adenocarcinoma (13.5 months), but the difference was not statistically significant (P = 0.101). The results of multivariate analysis showed that the short-term response was an independent prognostic factor, and the prognosis of patients achieving partial response was better than that of the patients achieving stable disease (the hazard ratio was 0.467, the 95% confdence interval was 0.238 to 0.916; P = 0.027). Conclusion: For patients with unresectable stage III NSCLC, TAI chemotherapy is an effective and safe neoadjuvant therapy, especially for patients with partial response or preoperative diagnosis of squamous cell carcinoma, and the postoperative survival benefits are more significant.

Transcatheter arterial infusion chemotherapy increases expression level of miR‑142‑5p in stage III colorectal cancer.

OBJECTIVE: To investigate the expression level of miR-142-5p and its potential target gene endothelial PAS domain protein 1(EPAS1) in Stage III colorectal cancer during Transcatheter arterial infusion chemotherapy (TAI). MATERIALS AND METHODS: Illumina high-throughput sequencing was used to obtain miRNA expression profiles of paired tumor and adjacent normal tissues from one patient received TAI 1 week before the operation and another patient directly underwent an operation. The expression levels of miR-142-5p was measured with both high-throughput sequencing and quantitative real time-polymerase chain reaction. RESULTS: The expression levels of miR-142-5p, were significantly reduced in tumor tissues of stage III CRC, then significantly increased in tumor tissues receiving TAI and higher than tumor tissues without TAI. The apoptosis rate of HT-29 colon cancer cells was mildly increased after transfection with pre-miR-142. miR-142-5p could bind directly to the 3´untranslated region of endothelial PAS domain protein 1 and reduce its expression. CONCLUSIONS: miR-142-5p is a potential tumor suppressor in CRC and is upregulated in tumor tissues after TAI, suggesting its potential clinical values for testing the functionality of TAI and predicting the progress of CRC.

The effect of arsenic trioxide(As_2O_3) on mitochondria of hepatic Vx-2 carcinoma in rabbits by transcatheter arterial infusion / 重庆医科大学学报

Objective:To evaluate the action of arsenic trioxide(As 2O 3)on mitochondria of hepatic Vx-2 carcinoma by transcatheter arterial infusion(TAI).Methods:Fifty New Zealand rabbits weighing 2-3kg with hepatic Vx-2 carcinoma were randomly divided into five groups evenly.Two weeks after the tumor was implanted,the rabbits were treated with As 2O 3 (experimental groups),cisplatin or normal saline(control groups)by TAI for 7 days consecutively.Three weeks after drug administration,the mitochondrial morphological changes and mitochondrial specific surface areas of the tumor and hepatic tissues were investigated under transmission elcetron microscope,at the same time apoptosis of the tumor was observed.Results:The mitochondrial morphological changes of tumor were obvious in the experimential groups as compared with control groups( P

Experimental study of arsenic trioxide on rabbits with hepatic Vx-2 carcinoma by transcatheter arterial infusion / 第三军医大学学报

Objective To evaluate the anticancer effect of arsenic trioxide (As 2O 3) on rabbits with hepatic Vx 2 carcinoma by transcatheter arterial infusion (TAI). Methods Rabbits with hepatic Vx 2 carcinoma were treated with As 2O 3 by TAI for 7 d consecutively. The tumor inhibitory rate and the average tumor weight were determined. The morphological changes of the tumor were observed with a transmission electron microscope. bax/bcl 2 and VEGF expressions were examined by immunohistochemistry. Results The average weight of the tumor was 7.99, 6.50, and 4.87 g, and the tumor growth inhibitory rates in the experimental groups were 50.31%, 59 58%, and 69 71%, respectively. Tumor growth was significantly inhibited as compared with that in the NS group ( P