CANCER MICROVESSEL INTERVENTION(CMI)

Fighting the Cancer

What’s new in cancer treatment:part I

CANCER MICROVESSEL INTERVENTION(CMI)

Cancer treatment is traditionally being treated with the modalities involving surgery, chemotherapy and radiotherapy either done alone or more commonly in combinations. Chemotherapy classically means the delivery of injectable drugs to the patient which has the cancer killing property. When patients are treated with general chemotherapy, chemo medicine will naturally spread throughout the body. Unfortunately, the drug distribution is not limited to only cancerous areas, but healthy areas as well. For this reason, general chemo has such strong side effects, and is not particularly successful as a therapy. Therefore, a new research is being conducted at many centres where transarterial chemo-injection are given instead of systemic chemotherapy. In this procedure a catheter is inserted and chemo medicine are given through the artery that supplies blood to the cancerous area. The advantage is a big increase in drug density inside cancer within a short period of time. The disadvantage is that the high drug density inside cancer is difficult to maintain, because the chemo medicine will eventually spread to the rest of the body along with blood very quickly. However, in this procedure, the side effects are less than the effects associated with systemic chemotherapy. So we are researching whether there is an effective way to keep the chemo medicine staying at the cancer site as long as possible, instead of spreading to the whole body, which may cause many serious side effects.

Cancer Microvessel Intervention (CMI) combines different chemo medicines into a fine grain particle. By using superselective catheterization, this fine grain particle will be distributed inside the artery which supplies the target cancer. These fine grain particles of chemo medicine will stay inside tumor tissue and maintain a high density for a long period of time. CMI is based on the following theory: there are a lot of gaps among the cancer capillary endothelial cells, and tight junctions among the normal capillary endothelial cells. The fine grain chemo particle will go inside the interstitial space of cancer tissue, which causes an increase osmotic stress, selectively constricts the cancer micro-capillary, and then block the blood flow. Therefore, the fine grain particle chemo will stay for a relatively long time inside the tumor. Meanwhile, because of the small size, there will not be embolism (blockage) in the normal capillary. Because it is possible to use so much less chemo medicine, the side effects on the entire body are much less than with systemic chemotherapy.

Advantages of CMI

There is an example which helps you understand the advantages of CMI.

If a patient weights 60kg and the tumor weights 50g(0.05kg)

General  chemo by vein infusion	If we give 150mg of drug(oxaliplatin) by vein infusion, there is only 0.125mg of this drug inside the tumor, others will inflow to other organs of body.
Cancer Microvessel   Intervention (CMI)	Just 15mg of the same drug by superselective catheterization and intervention. For example, two thirds (10mg) of the drug has been distributed throughout the body via blood circulation; only one third (5mg) of that remains in the targeted tumor tissue. The dose of chemo medicine remaining inside tumor is 40 times greater than with general chemo vein infusion. (5mg=0.125mg X 40)