title: Synergy in cancer treatment between liposomal chemotherapeutics and thermal ablation.
abstract: Minimally invasive image-guided tumor ablation using short duration heating via needle-like applicators using energies such as radiofrequency or microwave has seen increasing clinical use to treat focal liver, renal, breast, bone, and lung tumors. Potential benefits of this thermal therapy include reduced morbidity and mortality compared to standard surgical resection and ability to treat non-surgical patients. However, improvements to this technique are required as achieving complete ablation in many cases can be challenging particularly at margins of tumors>3 cm in diameter and adjacent to blood vessels. Thus, one very promising strategy has been to combine thermal tumor ablation with adjuvant nanoparticle-based chemotherapy agents to improve efficiency. Here, we will primarily review principles of thermal ablation to provide a framework for understanding the mechanisms of combination therapy, and review the studies on combination therapy, including presenting preliminary data on the role of such variables as nanoparticle size and thermal dose on improving combination therapy outcome. We will discuss how thermal ablation can also be used to improve overall intratumoral drug accumulation and nanoparticle content release. Finally, in this article we will further describe the appealing off-shoot approach of utilizing thermal ablation techniques not as the primary treatment, but rather, as a means to improve efficiency of intratumoral nanoparticle drug delivery.
authors.affiliation: Minimally Invasive Tumor Therapy Laboratory, Section of Interventional Radiology, Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, 330 Brookline Ave, Boston, MA 02215, USA. mahmed@bidmc.harvard.edu
authors.forename: Muneeb
authors.initials: M
authors.lastname: Ahmed
authors.forename: Marwan
authors.initials: M
authors.lastname: Moussa
authors.forename: S Nahum
authors.initials: SN
authors.lastname: Goldberg
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant / Q000379:methods*; D004317:Doxorubicin / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D008081:Liposomes; D009369:Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D008081:Liposomes; D004317:Doxorubicin