Feasibility of EUS-guided injection of irinotecan-loaded microspheres into the swine pancreas.

Abstract

BACKGROUND:

LC beads (Biocompatibles International plc) are designed for the time-released delivery of the chemotherapeutic agent irinotecan into focal, hypervascularized, hepatic tumors.

OBJECTIVE:

To determine the feasibility of EUS-guided injection of LC beads (with/without irinotecan) into the swine pancreas.

DESIGN:

Survival animal study.

SETTING:

Academic center.

SUBJECTS:

This study involved 12 Yorkshire swine.

INTERVENTION:

LC beads without irinotecan and loaded with up to 300 mg of irinotecan were injected under EUS guidance with a 19-gauge needle into the tail of the pancreas. CT scanning and necropsy with histology were performed at day 7.

MAIN OUTCOME MEASUREMENTS:

Feasibility of the injections, gross and microscopic evidence of pancreatic inflammation, and clinical tolerance by the animals.

RESULTS:

After injection of LC beads with/without irinotecan, in 10 of 12 animals an intrapancreatic, hyperechoic focus with an average diameter of 2.2 cm was visible by EUS, and a hypodense area in the tail of the pancreas was visible by contrast CT. In 2 animals (1 with irinotecan and 1 without) no beads were seen on CT. In 10 of 12 animals, a depot of beads was located in the tail of the pancreas on gross inspection and histology. Drug depot with only localized pancreatic tissue reactions was seen on histopathologic review.

LIMITATIONS:

Animal study.

CONCLUSION:

The EUS-guided injection of LC beads (with/without irinotecan) into the pancreas of the pig is feasible and safe. This technique is a potential minimally invasive local treatment option for locally advanced pancreatic cancer.

• Authors: Cetin Karaca, Sevdenur Cizginer, Yusuf Konuk, Avinash Kambadakone, Brian G Turner, Mari Mino-Kenudson, Dushyant V Sahani, Chelsea Macfarlane, William Brugge
• Journal: Gastrointestinal endoscopy (Gastrointest Endosc) Vol. 73 Issue 3 Pg. 603-6 (Mar 2011) ISSN: 1097-6779 [Electronic] United States
• PMID: 21238959 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Chemical References

• Topoisomerase I Inhibitors
• Irinotecan
• Camptothecin

Topics

• Animals
• Camptothecin (administration & dosage, adverse effects, analogs & derivatives)
• Feasibility Studies
• Injections
• Irinotecan
• Microspheres
• Necrosis (etiology)
• Pancreas (diagnostic imaging, drug effects, pathology)
• Swine
• Tomography, X-Ray Computed
• Topoisomerase I Inhibitors (administration & dosage, adverse effects)
• Ultrasonography, Interventional