Innovative New Treatments and Combination Therapies Discussed on Day 2 of Interventional Oncology Meeting
MIAMI, Saturday, November 5, 2016 – Knowledge sharing continued yesterday at the Synergy Miami meeting with presentations by leading interventional oncologists. A breakfast symposium addressed the growing role of ablation in spinal tumor treatment. Ablation is a therapy that is evolving from a palliative care to a treatment that can achieve local tumor control.
The morning sessions focused on hepatocellular carcinoma (HCC). Eugene R. Schiff, MD, discussed the increased incidence of nonalcoholic steatohepatitis (NASH) and related incidence of HCC. Patients with NASH are identified not by oncologists, said Schiff, but by primary care clinicians, hepatologists, and gastroenterologists who care for patients with cirrhosis. Screening and monitoring of these patients must be improved to better treat NASH patients, he added.
Riccardo Lencioni, MD, shared an update on image-guided ablation, noting that based on recent data, microwave ablation may be breaking the 3-cm barrier for ablation. Ablation and resection are equally effective for small HCC tumors, he said, and they are now considered complementary, not competitive procedures. He added that novel technologies and combination therapies overcome some of the limitations of RFA in intermediate size tumors, but another important challenge persists.
“The high rate of recurrence after curative therapy remains a major clinical issue,” said Lencioni. “Immuno-oncology could help as a potential problem solver, whereby one day we may deliver a kind of vaccine therapy with treatment.”
Govindarajan Narayanan, MD, shared details of one of the first cases using radiopaque embolic beads. At 1-month follow-up, most of the tumor was necrosed, with some enhancement. The patient had repeat TACE 5 months later, and an MRI 3 weeks later showed complete response. The patient underwent transplant 2 months later, and the explanted specimen showed 90% tumor necrosis, an early predictor of the efficacy of these drug-eluting beads.
Daniel Sze, MD, described research starting more than 100 years ago that found an oncolytic property of viruses. The rationale for oncoltyic virotherapy is complicated and still not well understood. The main mechanism is probably immunomodulation, said Sze. The virus activates the immune system to attack tumor, and can cause an abscopal effect even when applied locoregionally. “Viruses could be a huge opportunity for us,” he said.
Challenging cases were discussed during the HCC tumor board that followed. The second day of the conference concluded as attendees engaged in a hands-on ablation workshop, and had the opportunity to attend sessions on musculoskeletal and spinal tumors, as well as lung cancer.
Republished with permission from the Synergy Show Daily 16, the official show daily for the Synergy Miami 2016 multidisciplinary interventional oncology meeting, November 4, 2016.
