(UroToday.com) The 2022 EAU annual meeting featured a session on new insights in the management of upper tract urothelial cancer, including a presentation by Dr. Gilad Amiel discussing a biodegradable device for controlled release of cisplatin as local chemotherapy for bladder cancer. The usual treatment for bladder tumors after local resection is an installation of chemotherapy or immunological treatment. However, these treatments are challenging due to short exposure time or dilution by urine production. Dr. Amiel and colleagues have developed a biodegradable device that gradually releases cisplatin into the urinary tract in order to eliminate cancer cells. The device is lodged in the renal pelvis, as an alternative strategy for injecting substances into the bladder.
Using PLGA-produced poly-lactic-glycolic-acid nanofibers, the authors were able to trap within the polymer matrix the cisplatin that would be released into the urine stream with the gradual breakdown of the device. They tested the ability to build a device that would sit in the renal pelvis, the amount of cisplatin that could be loaded on the device, the rate of release of cisplatin at different concentrations, and the response of different TCC cell lines to exposure to cisplatin released from the disintegrated device:
The device was built in the shape of KORIGAMI in order to maximize surface area. Cisplatin was imprinted in various concentrations (1.17-2.34% w / w). In a bioreactor that simulates artificial urine interaction with the device, a cisplatin release rate of 26% of its contents within the first 6 hours and a release of 94% of the contents after a week at a flow rate of 30 ml/hour was demonstrated. The stent completely disintegrated within 4 weeks. Two TCC cell lines were tested (T24 & NTB9) and apoptosis was demonstrated within a few hours at all concentrations tested.
Dr. Amiel concluded this presentation by discussing a biodegradable device for controlled release of cisplatin as local chemotherapy for bladder cancer with the following take home messages:
- This study attempted to build a nanofiber model as a reservoir for active substances trapped in a polymer, that decomposes under urinary flow conditions
- Additionally, this study developed a stent that releases at a predetermined rate, a drug for a period of about several weeks
- It is anticipated that the location of the device in the renal pelvis will reduce bladder irritation of existing stents, and next steps are to implant the device in the renal pelvis of a swine model
- A device that allows for long-term controlled release will provide a significant advantage over existing bladder cancer treatments that require multiple instillations
Presented by: E. Gilad Amiel, MD, Rambam Health Care Campus, Dept. of Urology, Haifa, Israel
Co-Authors: Bukchin-Tihomirov A.2, Kabha A.2, Hoffman A.1, Zussman E.2
Affiliations: 1Rambam Health Care Campus, Dept. of Urology, Haifa, Israel, 2Technion, Faculty of Mechanical Engineering, Haifa, Israel
Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Assistant Professor of Urology, Georgia Cancer Center, Augusta University/Medical College of Georgia, @zklaassen_md on Twitter during the 2022 European Association of Urology (EAU) Annual Hybrid Meeting, Amsterdam, NL, Fri, July 1 – Mon, July 4, 2022.