European Conference on Interventional Oncology
ECIO countries

April 13-16 | Rotterdam, NL

April 13-16 | Rotterdam, NL

April 13-16 | Rotterdam, NL

April 13-16 | Rotterdam, NL

April 13-16 | Rotterdam, NL

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ProgrammeSneak peeksOngoing research in interventional oncology: What is around the corner?

Ongoing research in interventional oncology: What is around the corner?

Three things you will learn at my lecture

    1. Developments such as robotic-assisted procedures, augmented reality, and HFIRE are enhancing precision in interventional oncology and reducing damage to surrounding tissues.
    2. Ongoing research explores the potential benefits of combining interventional oncology with systemic treatments like immune checkpoint inhibitors, with encouraging results in liver cancer.
    3. Advances in biomarkers, liquid biopsies, and AI are improving the ability to personalize interventional oncology treatments, aiding in patient selection and treatment monitoring.

Dr. Annabella Shewarega
Speaker bio
 

Add this session to your calendar!

Interventional oncology (IO) continues to redefine the landscape of cancer treatment through minimally invasive, image-guided procedures. This dynamic subspecialty of interventional radiology has experienced significant technological and clinical advancements in recent years, driven by the need for precise, effective, and patient-centered therapies. This lecture will outline the latest technological innovations, highlight key research studies and clinical trials, and discuss the future directions of IO research.

Technological advancements in interventional oncology

Recent technological breakthroughs in IO are transforming the way cancer is treated. Among these advancements, robotic-assisted procedures are paving the way for unparalleled precision. Robotic systems equipped with artificial intelligence (AI) now assist with needle guidance and navigation during ablation procedures, significantly reducing operator variability and improving outcomes [1,2]. Platforms that integrate robotics with real-time imaging to enhance accuracy in targeting tumors are currently under development.

Another critical development is the refinement of advanced imaging modalities. Dual-energy computed tomography (DECT), functional MRI, and hybrid imaging techniques such as PET/MRI are becoming standard in many centers, enabling precise tumor characterization and treatment planning. Coupled with augmented reality (AR) and virtual reality (VR) applications, these imaging modalities allow for pre-procedural planning and intra-procedural guidance in ways that were unimaginable just a few years ago [3,4].

In the field of tumor ablation, high-frequency irreversible electroporation (HFIRE) is emerging as a promising technique for treating solid tumors near critical structures. Unlike thermal ablation techniques, HFIRE uses short electrical pulses to disrupt cancer cell membranes without causing significant heat-related damage to surrounding tissues, making it particularly useful for treating pancreatic and hepatic malignancies [5].

Similarly, drug-eluting microspheres for transarterial chemoembolization (TACE) and radiopharmaceuticals such as Yttrium-90 microspheres continue to evolve. Recent innovations focus on improving drug delivery by developing microspheres capable of releasing immunomodulatory agents in addition to chemotherapeutics, enabling combination therapies that can augment the immune response against tumors [6,7].

Recent research studies and clinical trials

Ongoing research in IO reflects a strong focus on integrating IO techniques with systemic therapies such as immunotherapy and targeted therapies. Notably, recent clinical trials have explored the synergistic effects of combining immune checkpoint inhibitors (ICIs) with IO procedures.

  1. TARE With Immunotherapy Trials: Trials investigating transarterial radioembolization (TARE) with immune checkpoint inhibitors have yielded encouraging results for hepatocellular carcinoma (HCC). A Phase I/IIa trial investigated the combination of Y90 radioembolization with durvalumab, an anti-PD-L1 therapy, in patients with locally advanced unresectable HCC, demonstrating promising efficacy and safety [9].
  2. Non-Invasive Biomarkers: Studies on non-invasive imaging biomarkers are also a key area of focus. Researchers are developing imaging tracers that target specific tumor microenvironment markers, such as hypoxia and angiogenesis. These tracers enable the early detection of treatment response and provide real-time feedback, potentially replacing invasive biopsy techniques [10,11].
  3. Liquid Biopsies in IO: Clinical trials are investigating the use of circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs) as biomarkers to monitor the efficacy of IO treatments like TACE and ablation. Early findings suggest that integrating liquid biopsies into IO workflows could help stratify patients more effectively and guide personalized treatment plans [12–14].

Future directions in interventional oncology

Genomic-guided IO therapies are on the horizon. As our understanding of cancer genomics deepens, IO procedures will likely be tailored to target specific genetic mutations within tumors. For example, researchers are exploring how CRISPR-based gene-editing techniques can be delivered directly to tumors via catheter-based systems, opening new avenues for treating cancers that are resistant to conventional therapies [15].

Another promising direction is the integration of artificial intelligence (AI) in IO. AI algorithms are being trained to analyze imaging data, predict treatment outcomes, and optimize procedural planning. These advancements could significantly enhance decision-making, particularly in complex cases involving multiple tumor sites or high-risk patients [16].

Lastly, as IO procedures become more sophisticated, there is a growing emphasis on understanding the tumor microenvironment (TME). Targeting the TME through embolization, ablation, or drug delivery is a promising strategy for mitigating tumor progression and enhancing the efficacy of systemic therapies. Research into modulating the TME will likely drive the development of combination therapies that integrate IO with cutting-edge systemic treatments [3,17].

Conclusion

Interventional oncology stands at the forefront of cancer care, offering minimally invasive solutions that address both the primary tumor and the systemic nature of cancer. The ongoing integration of IO with immunotherapy, genomics, and AI heralds an exciting future where patients receive treatments tailored to their unique tumor biology. As clinical trials continue to produce groundbreaking findings, interventional oncology will remain a critical component of multidisciplinary cancer care, pushing the boundaries of what is possible in the fight against cancer.

Annabella Shewarega

Yale University, New Haven/US

Dr. Annabella Shewarega is a medical doctor, having graduated from University Hospital Essen in Germany, and a PhD candidate in Biology at the University Duisburg-Essen, Germany. She currently holds a position as a Postdoctoral Associate at the Yale Interventional Oncology Lab in the Department of Radiology and Biomedical Imaging at Yale School of Medicine. Her research focuses on the development of advanced quantitative imaging biomarkers for the diagnosis, characterization, and treatment of liver cancer. Additionally, Dr. Shewarega is investigating the integration of artificial intelligence solutions in liver cancer management and developing tools to assess the tumor microenvironment and immune system in the context of loco-regional, image-guided therapies for liver cancer.

 

References

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  2. Altun I, Demirlenk YM, Atar D, et al. Advances and Challenges in Interventional Immuno-Oncology Locoregional Therapies. J Vasc Interv Radiol. 2024;35(2):164–172. doi: 10.1016/j.jvir.2023.10.009.
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