totally new approach--cryoablation of tumor,followed immunotherapy wth lymphnodecells

[Lani]

Cryobiology. 2006 Sep 12; [Epub ahead of print] Links
Adoptive immunotherapy of breast cancer with lymph node cells primed by cryoablation of the primary tumor.

Sabel MS,
Arora A,
Su G,
Chang AE.
University of Michigan, Department of Surgery, Division of Surgical Oncology, 3304 Cancer Center, 1500 East Medical Center, Ann Arbor, MI 48109-0932, USA.
Cryoablation of cancer leaves tumor-associated antigens intact in an inflammatory microenvironment that can stimulate a regional anti-tumor immune response. We examined whether cryoablated tumor draining lymph nodes (CTDLN) as adoptive immunotherapy may be an effective immunotherapeutic approach in the adjuvant treatment of breast cancer. BALB/c mice with MT-901 mammary adenocarcinoma tumors underwent cryoablation, resection or no treatment and tumor draining lymph nodes were harvested. Cryoablation resulted in only a mild increase in the absolute number of T-cells but a significant increase in the fraction of tumor-specific T-cells as evidenced on IFN-gamma release assay. FACS analysis demonstrated no significant relative shift in the proportion of CD4(+) or CD8(+) cells. The adoptive transfer of CTDLN resulted in a significant reduction of pulmonary metastases as compared to TDLN from either tumor-bearing mice or mice who underwent surgical excision. Cryoablation prior to surgical resection of breast cancer can be used as a method to generate effector T-cells for adjuvant adoptive cellular immunotherapy.
PMID: 16973145 [PubMed - as supplied by publisher]

[Bev]

Hi,

I was planning to participate in a trial last summer to get it frozen before removal. Surgeon felt like it was just easier to locate it frozen amongst the cottage cheese.

I'm bummed it didn't work out. The hospital (Reston, VA) forgot to order the nuclear meds for the SNB. Nothing like being prepped for surgery and having it called off. Livid comes to mind.

There seem to be many advantages to doing surgery this way. I think you can search mammotone to get some info on this. BB

[Lani]

I think mammotome is something completely different. If not, let me know!

[Bev]

It is a core vacuum assisted biopsy so yes it is different. It came to mind as I think the same company manufactures the machinery for both procedures. BB

[Lani]

or perhaps they were trying to both treat it and utilize the lymph node cells in a vaccine!

1: Am J Surg. 2006 Oct;192(4):462-70. Links
Prospective randomized study comparing cryo-assisted and needle-wire localization of ultrasound-visible breast tumors.

Tafra L,
Fine R,
Whitworth P,
Berry M,
Woods J,
Ekbom G,
Gass J,
Beitsch P,
Dodge D,
Han L,
Potruch T,
Francescatti D,
Oetting L,
Smith JS,
Snider H,
Kleban D,
Chagpar A,
Akbari S.
Anne Arundel Medical Center, 2002 Medical Pkwy., Suite 120, Annapolis, MD 21401, USA.
BACKGROUND: This study compared the surgical results of 2 localization methods-cryo-assisted localization (CAL) and needle-wire localization (NWL)-in patients undergoing breast lumpectomy for breast cancer. METHODS: A total of 310 patients were treated in an institutional review board-approved study with 18 surgeons at 17 sites. Patients were randomized 2:1 to undergo either intraoperative CAL or NWL. A cryoprobe was inserted under ultrasound guidance in the operating room and an ice ball created an 8- to 10-mm margin around the lesion. The palpable ice ball then was dissected. NWL was placed according to institutional practice and resection was performed in a standard fashion. Surgical margins, complications, re-excisions, tissue volume, procedure times, ease of localization, specimen quality, and patient satisfaction were evaluated. Positive margins were defined as any type of disease present 1 mm or less from any specimen edge. RESULTS: Positive margin status did not differ between the 2 groups (28% vs. 31%). The volume of tissue removed was significantly less in the CAL group (49 vs. 66 mL, P = .002). Re-excisions were similar in both groups. CAL was superior in ease of lumpectomy, quality of specimen, acute surgical cosmesis, short-term cosmesis, patient satisfaction, and overall procedure time for the patient. CAL had a lower invasive positive margin rate (11% vs. 20%, P = .039) but a higher observed ductal carcinoma in situ-positive margin rate (30% vs. 18%, approaching statistical significance, P = .052). CONCLUSIONS: CAL is a preferred alternative to standard wire localization because it provides a palpable template, removes less tissue and improves cosmesis, decreases overall procedure time, and is more convenient for the patient and surgeon.
PMID: 16978950 [PubMed - in process]

[Bev]

This was the study I was in as I see my surgeon listed. Wished it would have worked out. BB