|M.Sc Student||Shoham Efrat|
|Subject||Efficiency Estimation and Safety of Intratumor Chemotherapy|
Treatment via a Multi-needle Device of a
Superficial Bladder Cancer
|Department||Department of Medicine||Supervisors||? 42? Ofer Nativ|
|Professor Raymond Coleman|
|Full Thesis text - in Hebrew|
Introduction: Bladder cancer is the fourth most common cancer in men (eighth in women) and is divided into two main categories: superficial (up to 75%) and invasive. In cases of superficial cancer the standard approach following tumor resection consists of adjuvant therapy (chemotherapy or immunotherapy) given via a urethral catheter. However, there is a high recurrence rate (50-80%), mainly due to residual cancer cells, which are not adequately exposed to the intravesical agents.
Hypothesis: Delivery of therapeutic agents into the bladder wall, using a novel multi-needle device, will permit better penetration, increase local drug concentration and extend drug exposure to the remaining dysplastic/neoplastic cells located at the base of the resected areas.
Objectives: To examine the feasibility of using a novel multi-needle device to introduce common chemotherapeutics to the bladder wall and to compare its safety and efficacy to standard methods.
Results: Injection of emulsions and dyes into swine bladders using the novel catheter revealed homogeneous drug penetration up to 3mm depth and 3cm width.
Overall five sets of experiments including 102 mice with induced cancers have demonstrated improved efficacy of the multi-needle approach compared to the control groups. This was reflected by lower bladder weights, reduced volume of cancer and increased rates of apoptosis. Only few cases of metastases were found in the livers and lungs, which is not surprising, as our model involves a superficial bladder cancer known for its low metastatic potential. The effectiveness of the new method enables dose reduction leading to toxicity comparable to the other methods.
Conclusions: This technology provides advantages by allowing a homogeneous distribution of the agent into the treated area, injection to a predetermined depth, minimal drug loss during injection, more precise dosage and minimal agent clearance from the tissue. If it can be applied to human bladder cancer, this technology may improve patients' quality of life by shortening drug administration procedures, reducing number of treatment sessions and side effects and, and hopefully reduce recurrence rates.