O122 The use of directly injectable cancer therapies: a systematic review

Abstract

Abstract Introduction DIT allows for targeted delivery to a cancer. This could deescalate treatments through reduced use of systemic chemotherapy, radiotherapy dosage, and avoidance of major surgery. Palliative cancers can benefit through similar means to maintain quality of life and avoid permanent interventions (such as stomas). There is no mainstream use of DIT. Therefore, the aim of this review was to assess the role of DIT in all cancers. Methods A systematic search was performed in the Pubmed, Web of Science, Embase and Google databases. Two authors independently searched the literature and extracted data onto a dedicated proforma. Human and animal studies were included. Results 8,380 papers were identified, 49 studies were included; comprising of 1,087 patients for lung, H+N, brain, oesophagogastric and colorectal cancer. Four studies performed neoadjuvant DIT, where one showed all lung tumours down staged to an operative state. The remainder showed no advantage in survival or response. Palliative intra-tumoural cisplatin (in three studies) showed promise for malignant airway obstruction, where good responses were shown in > 50% of patients (single report). Cisplatin was also favourable in palliative H+N cancers (ORR=66% in one report). A minority of studies (4/49) exhibited grade 3 toxicity or higher. Conclusion DIT is safe to administer and demonstrated promise in the palliation of malignant airway obstruction and advanced/recurrent H+N cancer. Further studies are required to verify these results. Additionally, more reports are required to determine its role in neoadjuvant treatment. DIT:Direct injection of chemotherapy ORR:objective response rate H+N:head and neck