Freezing Lung Metastases Appears Promising

The freezing, or cryoablation, of cancer sites that have spread to the lung (lung metastases) appears promising among patients whose cancer continues to progress on chemotherapy. These results were presented at the 2013 annual meeting of the Society of Interventional Radiology.

The lung is a common site to which several types of cancers spread once they have reached an advanced stage. Unfortunately, patients with lung metastases are often considered incurable with standard therapies, so treatment is aimed at improving survival and providing a good quality of life.

The complete surgical removal of all lung metastases provides the greatest chance for long-term survival; however, patients are often unable to undergo the surgical procedure for reasons such as the location or extent of the lung metastases, or other medical conditions of the patient. Therefore, researchers continue to explore new ways in which to treat lung metastases.

Computed-tomography (CT)-guided cryoablation is a type of therapy that is being evaluated in several types of cancer for which standard therapies are not effective. CT-guided cryoablation involves the use of a probe, guided by CT scans, that is placed into the site of cancer and kills the cancer cells by freezing them. The freezing produces an ice ball that completely engulfs the tumor and can be visualized via the CT scan.

Researchers from the United States and France recently conducted a small clinical trial further exploring the potential benefits of CT-guided cryoablation among patient with lung metastases from various types of cancer. The trial, called the ECLIPSE study, was conducted at 3 centers in the United States and one in France.

The trial included 40 patients, 40% of whom had lung metastases from colon cancer and 23% from kidney cancer. All patients had lung metastases that continued to grow while being treated with chemotherapy.

Patients could only have up to 5 sites of lung metastases with no site measuring larger than 3.5 cm.

3 months following the procedure, 80% of patients had stable disease and the remaining 20% had a partial or complete regression of their cancer.
By 6 months, all patients but one, had continued disease stabilization or partial or complete regression of their cancer.
Of the 2 patients who received treatment at least 12 months ago at the time of evaluation, one continued to sustain a complete regression of cancer and one sustained a partial regression of cancer.
Side effects tended to be mild in nature, but the most common were pneumothorax (air in the chest cavity), pleural effusion (excess fluid accumulation around the lung) and pain in the chest of back.
The researchers concluded that these preliminary results appear promising for patients with lung metastases from different types of cancer. This may be particularly important for patients whose cancer has stopped responding to standard therapies. However, longer follow-up and larger trials are necessary to truly determine the clinical effects of this type of treatment.

Reference: DeBaere T, et al. Evaluating Cryoablation of Metastatic Lung/Pleura Tumors in Patients — Safety and Efficacy (ECLIPSE): Preliminary Safety Outcomes . 2013 annual meeting of the Society of Interventional Radiology. Abstract 33.