The oscillations of ultrasound (US) contrast agent microbubbles under their activation by US waves engender a modulation of the permeability of biological barriers amplifying hence the extravasation of drugs and/or fluorescent markers through a process known as sonoporation. In such a way, the bioavailability of the therapeutic agent is augmented only in the area where US waves are focused. The objective now is to translate this therapeutic approach to the clinic by performing a feasibility study with the development of a therapy regime optimized for hepatic metastases of colorectal cancer. In order to demonstrate the clinical feasibility of the therapeutic approach based on ultrasound and microbubbles, we will focus on patients with liver metastases of colorectal cancer treated with monoclonal antibodies in combination with chemotherapy.
Despite the increasing number of active molecules and the availability of news targeted therapies for cancer, therapeutic achievements remain modest for a number of tumor types. One of the major obstacles is inherent to the absence of specific delivery in the tumor tissue. We have demonstrated recently that the oscillations of ultrasound (US) contrast agent microbubbles under their activation by US waves engender a modulation of the permeability of biological barriers amplifying hence the extravasation of drugs and/or fluorescent markers through a process known as sonoporation. In such a way, the bioavailability of the therapeutic agent is augmented only in the area where US waves are focused. The objective now is to translate this therapeutic approach to the clinic by performing a feasibility study with the development of a therapy regime optimized for hepatic metastases of colorectal cancer. In order to demonstrate the clinical feasibility of the therapeutic approach based on ultrasound and microbubbles, we will focus on patients with liver metastases of colorectal cancer treated with monoclonal antibodies in combination with chemotherapy. The work aims into evaluating the therapeutic efficacy of the proposed approach on a number of selected patients. We will follow the usual treatment schemes and we will apply imaging protocols to visualize tumor progression. This technique of optimization of the intratumoral availability of anticancer drugs and based on sonoporation will improve the efficacy and safety of systemic chemotherapy by providing increased tumor uptake relative to normal tissue. This technique provides an ideal and easy strategy to optimize intratumoral drug delivery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
7
Magnetic Resonance Imaging
Perfusion Computerized tomography scan
Contrast enhanced ultrasound
Gaseous microbubbles (Sonovue) combinated with Ultrasounds
Service d'Hépatogastro-entérologie CHRU de TOURS
Tours, France
Objective response for liver metastases
Objective response for liver metastases with spiral CT scan and defined as decrease of at least 30% in the longer diameter of each selected liver metastases
Time frame: 2 months
Safety
Safety based on National Cancer Institute (NCI), Common Terminology Criteria for Adverse events (CTCAE)
Time frame: Day 3, Day 17, Day 32, Day 47
Tolerance
Tolerance based on National Cancer Institute (NCI), Common Terminology Criteria for Adverse events (CTCAE)
Time frame: Day 3, Day 17, Day 32, Day 47
Maximum percent reduction in tumor density on CT scan
Maximum percent reduction in tumor density (Hounsfield units) from baseline
Time frame: 2 months
Maximum percent reduction in tumor density on MRI
Maximum percent reduction in tumor density from baseline
Time frame: 2 months
Assessment of tumor vascularity by Perfusion CT scan
Assessment of tumor vascularity with Perfusion CT scan
Time frame: 2 months
Assessment of tumor vascularity by MRI
Assessment of tumor vascularity with MRI
Time frame: 2 months
Assessment of tumor vascularity by Dynamic Contrast-Enhanced US (DCE-US)
Assessment of tumor vascularity with Dynamic Contrast-Enhanced US (DCE-US)
Time frame: 2 months
Dosage of antibody anti-VEGF or anti-EGFR
Measures of serum concentration of antibody anti-VEGF or anti-EGFR
Time frame: Day1, Day 3, Day 15, Day 17, Day 32, Day 45
Dosage of antibody anti-VEGF or anti-EGFR by ELISA test
Pharmacokinetic of antibody anti-VEGF or anti-EGFR
Time frame: Day1, Day 3, Day 15, Day 17, Day 32, Day 45
Dosage of cytokines
Dosage of cytokines
Time frame: Day1, Day 3, Day 15, Day 17, Day 32, Day 45
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