Non-extended cryoablation could be a new strategy in lung cancer management: An experiment on green fluorescent protein-labeled Lewis lung cancer-bearing mice

Is cryoablation still suitable for advanced non-small cell lung cancer after failure of first-line chemotherapy? A multicenter, prospective, randomized-controlled trial of eighty-seven patients

The aim of this study was to investigate the therapeutic effect of cryoablation treatment in advanced NSCLC patients who had failed first-line chemotherapy. Eighty-seven patients from ten hospitals in China were enrolled into the study, forty-four patients received cryoablation treatment plus basic treatment (experimental group), and forty-three patients had basic treatment alone (control group). Follow-up was performed once every three months until the end of the study or the death of the patient. The primary endpoints were overall and post-intervention survival; secondary endpoints included tumor markers, solid tumor efficacy, and symptom changes before and after treatment. There was no significant difference in median OS between the two groups of patients (9.0 months vs 11.2 months, P = 0.583). The disease control rate (DCR) and living quality of the experimental group was higher than that of the control group. In terms of OS, indiscriminate use of cryoablation for such patients was not beneficial, though it could improve symptoms of patients. Cryoablation had a significant effect on selected advanced NSCLC patients after the failure of first-line chemotherapy.

Untargeted metabolomics profiling in a mouse model of lung cancer treated with thermal ablation

Thermal ablation is widely used in the treatment of lung cancer and is beneficial for the overall survival of patients in clinic. However, there is barely a priority in which ablation system should be chosen under different periods of tumor progression in lung cancer. The present study investigated different modes of thermal ablation systems in mice with transplanted Lewis lung carcinoma tumors and their various biological effects in local regions using untargeted metabolomics. The results showed that thermal ablation could significantly suppress tumor growth and the differentially expressed metabolites of tumors after ablation relative to untreated tumors concentrated on organic compounds, organic acids and derivatives, nucleosides, nucleotides, and lipids. The upregulated metabolites indicated an inflammatory reaction in the ablation groups at an early stage after ablation. Steroid hormone and tryptophan metabolism, which are associated with immune responses, were modulated after both cryoablation and hyperthermal ablation. Characteristically, the results also indicated that cryoablation suppressed glucose oxidation and carbohydrate metabolism of tumor, while hyperthermal ablation suppressed lipid metabolism of tumor. In conclusion, thermal ablation could inhibit tumor growth under either freezing or heating modes with characteristic different biological effects on tumors.

0 °C is better?- Thawing temperature optimization study for cancer cryoablation in a mouse model with green fluorescent protein-labeled Lewis lung cancer

PURPOSE

There are two kinds of thawing temperatures commonly adopted in cancer cryosurgery. We attempted to compare their efficacy differences in this study to optimize the surgical method.

METHOD

Forty-five C57BL/6 J mice with GFP-labeled Lewis lung cancer were randomized into three groups (n = 15 for each): control group, T0 group (thawing temperature 0 °C), and T40 group (thawing temperature 40 °C). Cryoablation was performed using a combined surgical system. When the ice ball reached the border of the tumor, they were rewarmed to 0 °C and 40 °C, respectively, using a single freeze-thaw cycle. After the surgery, weight of these mice, length/width and the fluorescence intensity (FI) of the tumors were recorded. All mice were sacrificed on Day 14 after the procedures and their xenografts were excised and weighed immediately. We also checked for pulmonary metastasis, and examined tumor specimens using HE staining.

RESULTS

Body weights, tumor volumes and FI in the three groups did not differ significantly at baseline. On Day 14, 39% of the tumors in the T0 group decreased in volume, whereas only 17% in the T40 group did. The average FI in the control group increased by 60%, but declined by 72% in T0 mice and 69% in T40 mice. Tumor inhibition rates were 71.64% in the T0 group and 68.12% in the T40 group. Lung metastases rates and histological changes were compatible between the two intervention groups.

CONCLUSION

Using 0 °C as the thawing temperature may have more potential benefits in cryoablation efficacy.