La cryoablation percutanée pour certaines tumeurs.

Combining nanodrug-based chemotherapy and cryoablation provides an effective strategy to eliminate cancer stem-like cells (CSCs) -- the root of cancer resistance and metastasis, which will help to improve the safety and efficacy of treating malignancies that are refractory to conventional therapies.

Cryoablation (also called cryosurgery or cryotherapy) is an energy-based, minimally invasive surgical technique that has been investigated to treat a variety of diseases including cancer, which is done by freezing the diseased tissue to subzero temperature to induce irreversible damage. It is particularly attractive for fighting against breast cancer due to its excellent cosmetic outcome to preserve the organ with unnoticeable scar formation on skin. However, cryoablation alone has limited effectiveness on eradicating cancer stem-like cells (CSCs), which may lead to cancer recurrence and/or metastasis post operation. A team of researchers from the Department of Biomedical Engineering and Comprehensive Cancer Center at The Ohio State University introduced an innovative strategy by combining cryoablation with nanoparticle-medicated chemotherapy and demonstrated that the combined therapy can significantly augment the destruction of CSCs, resulting in eliminating nearly all CSCs. This technology provides a new approach to overcome drug resistance of CSCs and improve the safety and efficacy of cancer cryoablation.

"This novel combined therapy of cryoablation and nanodrug is a significant step forward in improving the safety and efficacy of fighting against cancer. Our study provides the first account of minimizing cancer recurrence by destroying the cancer stem-like cells in the field of cryoablation for cancer treatment." said Xiaoming He, Ph.D., of The Ohio State University and senior author of this paper. "It is valuable to facilitate the clinical applications of cryoablation by eliminating the root of cancer resistance -- the cancer stem-like cells."

"The nanoparticles used in this study were optimized for effective drug delivery." said Wei Rao, Ph.D., the lead author of the paper. According to the researchers, an optimized size of the nanodrug facilitates its uptake by cancer cells via endocytosis. A positively charged nanodrug has high electrostatic affinity to the negatively charged cell plasma membrane, which should further facilitate its uptake by cancer cells. Moreover, materials on the nanoparticles have high affinity to CD44 that is one of the common protein complexes overexpressed on cancer stem-like cells. Therefore, the use of nanodrug can help to achieve much-enhanced bioavailability of anticancer drug to cancer stem-like cells compared to conventional chemotherapy using free drug. This particularly attractive feature meets the demand of targeted delivery and therapy and could minimize the drug systemic toxicity. Its combination with cryoablation can significantly augment cryoinjury to ensure complete destruction of all cancer stem-like cells.

Currently, research on the combined therapy of cryoablation and nanodrug showed promising results using 3D mammosphere model at the microscale. Future research will focus more on in vivo studies to monitor tumor relapse after the combined treatment and further translate this technology into the clinic. Although more research is required to ascertain its safety and efficacy, this study provides a novel strategy of combining cryoablation and nanodrug that demonstrates great potential to eliminate cancer from its root -- the cancer stem-like cells.

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La combinaison de la chimiothérapie à base de nano-médicaments et de la cryoablation fournit une stratégie efficace pour éliminer les cellules souches semblables aux cellules cancéreuses (CCM) - la racine de résistance du cancer et des métastases, ce qui contribuera à améliorer la sécurité et l'efficacité du traitement des tumeurs malignes qui sont réfractaires aux traitements conventionnels .

La cryoablation (également appelée cryochirurgie ou cryothérapie ) est une technique chirurgicale mini-invasive basée sur l'énergie et qui a été étudiée pour traiter une variété de maladies, dont le cancer. Elle se fait par congélation du tissu malade à une température sous zéro pour induire des dommages irréversibles. Elle est particulièrement intéressante pour la lutte contre le cancer du en raison de son excellent résultat esthétique qui préserve l'organe de formation de cicatrices. Cependant , la cryoablation seule a une efficacité limitée sur l'éradication de cancer des cellules souches semblables à celles du cancer ( CCM ), ce qui peut conduire à une récidive de cancer et / ou de l'exploitation des métastases. Une équipe de chercheurs a présenté une stratégie innovante en combinant cryoablation avec la chimiothérapie nanoparticulaire médicamenteuse et a démontré que la thérapie combinée peut augmenter de façon significative la destruction des CSC, ce qui entraîne l'élimination de la quasi-totalité CSC. Cette technologie offre une nouvelle approche pour surmonter la résistance aux médicaments de CSC et d'améliorer la sécurité et l'efficacité de la cryoablation de cancer .

"Cette nouvelle thérapie combinée de la cryoablation et nano-médicaments est une étape importante dans l'amélioration de la sécurité et l'efficacité de la lutte contre le cancer . Notre étude fournit pour la première fois le fait de minimiser la récidive du cancer en détruisant les cellules souches semblables aux cancéreuses dans le domaine de la cryoablation pour le traitement du cancer. " Xiaoming dit, Ph.D. dit : " Il est utile de faciliter les applications cliniques de la cryoablation en éliminant la racine de résistance du cancer - les cellules souches du cancer. "

"Les nanoparticules utilisées dans cette étude ont été optimisés pour la livraison efficace des médicaments . " a dit Wei , Ph.D., auteur principal de l'article. Selon les chercheurs, une taille optimisée du nano-médicament facilite son absorption par les cellules cancéreuses par endocytose . Un nano-médicament chargé positivement a une affinité électrostatique élevée pour la membrane plasmique de la cellule chargée négativement, ce qui devrait faciliter son absorption par les cellules cancéreuses. En outre, les matériaux sur les nanoparticules ont une forte affinité pour CD44 qui est l'une des molécules de protéines les plus communément surexprimés sur les cellules souches semblables aux cellules canécreuses. Par conséquent, l'utilisation de nano-médicaments peut aider à atteindre une biodisponibilité nettement améliorée pour les médicaments anticancéreux à cellules souches par rapport à la chimiothérapie conventionnelle qui utilise le médicament neutre. Cette caractéristique particulièrement intéressante répond à la demande de la livraison et de la thérapie ciblée et pourrait réduire la toxicité systémique de la drogue. Sa combinaison avec la cryoablation peut augmenter de manière significative la cryolésion pour assurer la destruction complète de toutes les cellules souches comme le cancer .

Actuellement, la recherche sur la thérapie combinée de la cryoablation et nano-médicament a montré des résultats prometteurs en utilisant le modèle de mammosphere 3D à l'échelle microscopique . Les recherches futures devront se concentrer davantage sur des études in vivo pour surveiller la rechute de la tumeur après le traitement combiné pour traduire cette technologie pour la clinique. Bien que plus de recherches soient nécessaire pour s'assurer de sa sécurité et son efficacité, cette étude fournit une nouvelle stratégie combinant la cryoablation et les nano-médicaments qui démontre un grand potentiel d'éliminer le cancer de sa racine - les cellules souches qui ressemblent aux cellules cancéreuses.[/b]

Bonjour,

Pour info, Ce type d'intervention se pratique aussi à l'institut Montssouri à Paris, j'ai pris contact avec eux il y a quelque mois afin de voir s'ils ne pourraient pas supprimer ma récidive.
J'ai aussi pris contact à l’hôpital de Monaco ou on pratique ce genre d'intervention, mais à l'inverse sous forme de thermothérapie.
Toujours sur le front.
A suivre

(Mar. 3, 2010) — Freezing a cancer kills it in its place, and also appears to generate an immune response that helps stop the cancer's spread, leading to improved survival rates over surgery, according to a new study in mice from researchers at the University of Michigan Comprehensive Cancer Center.

Researchers looked at two different cryoablation techniques, which both involve applying a cold probe to a tumor to freeze it. The study was done in mice with breast cancer. One method involves freezing the tumor rapidly, in about 30 seconds; the other freezes the tumor slowly, taking a few minutes. Results from the cryoablation were compared to results from mice whose tumors were removed with surgery.

Geler un cancer le tue sur place et aussi semble générer une érponse immunitaire qui aide à arrêter le cancer de se répandre ce qui améliore les chances de survie après la chirurgie selon une nouvelle étude sur des souris.

Les chercheurs ont deux différentes techniques de cryoablation qui toutes les deux sont d'appliquer une sonde pour geler la tumeur. L'étude portait sur des souris avec le cancer du .Une des deux méthoses toutefois gèle le cancer plus rapidement en à peu près 30 secondes alors que l'autre prend quelques minutes. Les résultats des différentes méthodes ont été comparés avec les résultats de la chirurgie.

Both cryoablation techniques successfully killed the breast tumor. The mice treated with the rapid freeze had fewer tumors that spread to the lungs and improved survival compared to mice treated with surgery alone or mice treated with the slower freezing technique. The study showed that the benefit from the rapid freezing is likely due to changes in the immune system that help to kill the tumor. Freezing with the slower technique appeared to make the immune system not as able to kill the tumor.

Les deux méthodes de cryoablation ont tué les tumeurs du sein. Les souris traités avec la méthode rapide ont eu moins de tumeurs répandues dans les poumons et une survie plus longue comparées à celles traitées avec la seule chirurgie ou la méthode plus lente de cryoablation. Le bénifice est largement dûe à des changements dans le système immunitaire qui aide à tuer les tumeurs. La méthode plus lente rend le système immunitaire incapable de tuer les tumeurs.


The study appears online in Annals of Surgical Oncology. Based on these results from mice, researchers are now conducting a clinical trial using cryoablation in patients with breast cancer. In this trial, researchers use the rapid freezing technique.

Les chercheurs font une étude cliinique maintenant.

"Cryoablation has strong potential as a treatment for breast cancer. Not only does it appear effective in treating the primary tumor with little cosmetic concerns, but it also may stimulate an immune response capable of eradicating any cells that have traveled throughout the body, reducing both local and distant recurrence, similar to giving a breast cancer vaccine," says lead study author Michael Sabel, M.D., associate professor of surgery at the U-M Medical School.

La cryoablation a un fort potentiel pour traiter le cancer du

"What we learned in this study is that all cryoablation is not equal. The technique used to freeze the tissue can have a significant impact on how the immune system responds. The system we use today appears to be ideal for both destroying the tumor within the breast and generating an anti-cancer immune response," Sabel says.

U-M researchers are participating in a national clinical trial to evaluate using cryoablation for early stage breast cancer. Participants will undergo rapid freezing of their tumor, and their blood samples will be analyzed to assess changes in their immune system. All participants will be treated three to four weeks later with standard surgery to remove their tumor.

On analysera des échantillons de sang venant des personnes traitées avec la cryoablation.



Cryoablation is currently used routinely for prostate cancer, kidney cancer and a variety of cancers that have spread to the liver and bone.

Mar. 15, 2009 — Freezing kidney tumors—using a safe minimally invasive interventional radiology treatment that kills the cancer 100 percent effectively without surgery—should be the gold standard or first treatment option for all individuals with tumors that are 4 centimeters in size or smaller. And, this treatment—interventional cryoablation—is a viable option for people with larger tumors, according to two studies presented at the Society of Interventional Radiology's 34th Annual Scientific Meeting.

Geler les tumeurs du rein en utilisant une méthode sécuritare et minimalement invasive qui tue les cellules cancéreuses à 100% sans chirurgie devrait être la première option pour tout le monde avec des tumeurs de 4 centimètres ou plus petites. Et le traitement est une option aussi pour ceux avec des tumeurs plus larges.


"Interventional cryoablation is as effective as laparoscopic surgery (partial nephrectomy), the current gold standard treatment, and laparoscopic cryoablation surgery for treating renal cell carcinoma," said Christos Georgiades, M.D., Ph.D., interventional radiologist at Johns Hopkins Hospital in Baltimore, Md. "We can eliminate a cancer—that once it metastasizes can be notoriously difficult to treat and has a low chance of cure—with a simple outpatient procedure. Eliminating cancer at such an early stage is truly significant news for kidney cancer patients," he added.

It's important that individuals realize all their treatment options—especially since the incidence of kidney cancer has been steadily increasing in this country over the past 30 years, said Georgiades. Approximately 54,000 people are diagnosed with kidney cancer each year—with nearly 13,000 dying from it annually, according to recent statistics. Most people with this cancer are older, and the overall lifetime risk of getting kidney cancer is about 1 in 75—with men at higher risk than women. More than 75 percent of individuals who are diagnosed with kidney cancer have small tumors that are discovered incidentally. "Cryoablation is a great treatment option that doctors should discuss with patients early on," he explained.

The Hopkins studies, examining the safety and efficacy of percutaneous (no incision) cryoablation, show the treatment's powerful results. "Based on the results of our three-year study, we have shown that interventional cryoablation for kidney cancer should be the gold standard or the first treatment option for all patients whose tumors are 4 centimeters or smaller. It should be a viable option for patients whose cancer is even larger than that. And, ablation (or freezing) is a very effective option for patients who cannot or do not want to have surgery," noted Georgiades. Cryoablation's efficacy rate—the ratio of how many patients' renal cell carcinoma was destroyed completely for localized tumors by size—is 100 percent up to 4 centimeters (about 2 inches) and nearly 100 percent up to 7 centimeters (about 3 inches). Three localized 10-centimeter (about 4 inches) tumors—large tumors that are typically removed surgically—were treated; in two cases the tumor was successfully killed.

"This news is especially significant for individuals with small tumors, since more than 75 percent of patients who are diagnosed with kidney cancer have tumors that are 4 centimeters or less in size," said Georgiades. "These individuals can have their tumors treated completely, effectively, without surgery, with quicker recovery and mostly on an outpatient basis. Whatever the definition of 'cure' is, these results come as close to it as possible," he noted. "At Hopkins, interventional cryoablation is the first-line treatment for small tumors. Most of our patients go home the same day they receive treatment with minimal limitation on regular activities. With laparoscopic kidney surgery, a patient remains in the hospital for several days and recovery time can be from two to four weeks," he added. "Our studies highlight how effective interventional radiology treatments can be—not just for kidney cancer—but for other kinds of cancers and other diseases as well. Interventional radiology treatments will have a significant impact on the overall survival and benefits that patients can have from avoiding surgery," said Georgiades.

"There is no question that interventional cryoablation, which uses imaging to pinpoint tumors and probes to penetrate the skin to deliver freezing cold directly to a diseased tumor, works. This interventional treatment is not a widely known procedure yet, even to other doctors, and some patients are going to have to pursue it on their own," said Georgiades. The treatment is widely available in the United States at all major institutions and some smaller institutions as well; it is usually covered by health insurance.

Researchers followed kidney cancer patients who had received cryoablation for three years—well beyond the established and well-accepted one-year benchmark within the medical community to gauge the success of a kidney tumor treatment option—since most kidney tumors would be visible within a year with a CT scan or MRI. The use of percutaneous cryoablation should not be limited—as it has been—to patients who have other diseases that make surgery very high risk, cannot undergo anesthesia, have borderline kidney function, may only have one kidney or multiple recurring tumors or do not have any other option, said Georgiades. "There may be a bias in the medical community—among surgeons, primary care doctors and urologists—that cryoablation works only for certain patients with small tumors. This is not the case," emphasized Georgiades.

"Traditionally, laparoscopic surgery has been the main treatment option for all renal cell cancers; it literally cuts the cancer out. The good news is that individuals no longer need to have a kidney partially or completed removed to treat their cancer," noted Georgiades. When comparing the rate of complications between percutaneous cryoablation and surgery, Georgiades said that none of the patients who had cryoablation developed new or metastatic disease and they had fewer complications. The minimally invasive nature of interventional cryoablation means that it can be performed with minimal blood loss and without an incision, just a tiny hole in the skin. The interventional radiology treatment translates into significantly less pain, a shorter hospital stay and more rapid recovery. This safe treatment can be repeated, if necessary. The most common complication is a bruise around the kidney that goes away by itself, he said.

In studying cryoablation's efficacy, researchers looked at 90 tumors in 84 patients. Efficacy was determined based on a tumor's size at 3-, 6- and 12-month clinic visits and then yearly—with follow-up imaging with CT or MRI scans. Both efficacy and three-year survival rates approach 100 percent overall.

In studying cryoablation's safety, Georgiades studied the results of 101 percutaneous cryoablations on 91 patients who either couldn't undergo surgery or elected the interventional radiology treatment. Using computed tomography (CT) imaging, researchers could view tumors and probes in real time. Interventional cryoablation "has an excellent safety profile," said Georgiades.

Cryoablation is typically performed under light anesthesia, known as sedation, by an interventional radiologist who has consulted with the patient's urologist. One or more hollow needles are inserted through the skin directly into a tumor. Interventional radiologists can observe and guide the insertion by combined use of ultrasound and CT. The needle, or cryoprobe, is filled with argon gas, which creates an ice ball, which rapidly freezes the tumor. The tumor is then thawed by replacing the argon with helium. The procedure consists of two freezing and one thawing cycle, seeking a frozen margin beyond the tumor edge to ensure death of the entire tumor. After the cryoprobe is removed, a small bandage is placed over the skin puncture site. Cryoablation, which can also be referred to as cryo or cryotherapy, is approved by the Food and Drug Administration for treating soft tissue tumors, such as renal cell cancer.

D'après les chercheurs de la clinique Mayo, la cryoablation percutanée une méthode relativement non-invasise qui détruits les tumeurs en les gelant est une méthode sécuritaire pour traiter les tumeurs du :rein:chez des patients sélectivement choisis qui ne sont pas candidats pour une chirurgie.