Sequential Administrations of a Vascular-Disrupting Agent, High-Intensity Focused Ultrasound, and a Radioactively labeled Necrosis Avid Compound for Eradicating Solid Malignancies.

Authors: Li Y, Wang S, Chen L, Feng Y, Shen Z, Chen X, Huang G, Ni Y

Radical treatment of malignant solid tumors should aim to be less traumatic, precise, and effective. OncoCiDia, as a noninvasive, sequential dual-targeting, small-molecule, broad spectrum anticancer theranostic approach, may fulfill these requirements of solid cancer (Onco) treatment with both tumoricidal (Ci) and diagnostic (Dia) effects. However, it is unlikely to cure patients with cancer, especially those with large and irregular tumors and with tumors residing in certain organs, such as the brain and pancreas, because of insufficient necrosis generation. To amplify ablative efficacy, this shortcoming could be overcome by combining high-intensity focused ultrasound (HIFU) with the use of a vascular-disrupting agent (VDA) and a radioactively labeled necrosis avid compound (NAC), such as <sup>131</sup>I-Hypericin (<sup>131</sup>I-Hyp), which are the first and second targeting drugs used in OncoCiDia. This study proposes the combined use of OncoCiDia and HIFU (Onco-HIFU-CiDia) as a synergistic treatment for malignant tumors to achieve a curative multimodality and multidrug regimen for patients with solid cancers, in accordance with the current trend of cancer patient care.

Introduction

Purpose Other

Study Objective To propose combining OncoCiDia with high‑intensity focused ultrasound (Onco‑HIFU‑CiDia) as a synergistic multimodal approach to amplify tumor necrosis and improve curative treatment of malignant solid tumors.

Disease model Malignant solid tumors

Cargo name and characteristics Vascular-disrupting agent (VDA): a small-molecule tumor vascular disrupting drug used as the first-targeting agent to rapidly induce intratumoral vascular collapse and central necrosis; and 131I-Hypericin (131I-Hyp): a radioiodinated necrosis-avid small molecule (necrosis-avid compound, NAC) labeled with therapeutic/diagnostic radionuclide iodine-131, used as the second-targeting theranostic agent to selectively bind necrotic tumor tissue and deliver localized beta/gamma radiation.

Outcomes and Safety

Summary of Outcomes Combining OncoCiDia (VDA plus 131I‑Hypericin) with HIFU synergistically increases tumor necrosis and delivers localized beta radiation to eradicate residual peripheral cancer cells, improving ablation efficacy for solid tumors.

Safety-related matter The paper notes that increasing HIFU power can cause skin burns and pain (requiring analgesia and fractionated treatment), and suggests that pre-treatment with a vascular-disrupting agent could reduce these adverse effects.

Brain Region

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Ultrasound Parameters

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