The Desmoid Tumor Research Foundation

October 2022

Selective Intra-Arterial Doxorubicin Eluting Microsphere Embolization for Desmoid Fibromatosis: A Combined Prospective and Retrospective Study

Author Information

Elnekave E (1, 2), Ben Ami E (3), Shamai S (4), Peretz I (5), Tamir S (2), Bruckheimer E (6), Stemmer A (7), Erinjeri J (8), Quider AA (9), Seidensticker M (10), Wildgruber M (10), Ricke J (10), Anazodo A (11), Fung KF (12), Zer A (13), Ash S (14).

(1) Unit of Interventional Radiology, Shaare Tzedek Medical Center, Jerusalem 9103102, Israel. (2) Department of Diagnostic Radiology, Rabin Medical Center, Petah Tikva 4941492, Israel. (3) Sarcoma and Bone Oncology Unit, Oncology Division, Chaim Sheba Medical Center, Ramat Gan 52621, Israel. (4) Sarcoma and Bone Oncology Unit, Oncology Division, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel. (5) Davidoff Cancer Institute, Rabin Medical Center, Petah Tikva 4941492, Israel. (6) Section of Pediatric Cardiology, Schneider Children's Medical Center, Petah Tikva 4941492, Israel. (7) Oncology Division, Chaim Sheba Medical Center, Ramat Gan 52621, Israel. (8) Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA. (9) Department of Pediatric Hematology Oncology, Saban Pediatric Medical Center, Soroka University Medical Center, Beer Sheva 84101, Israel. (10) Department of Radiology, University Hospital, Ludwig Maximilian University, 80539 Munich, Germany. (11) Kids Cancer Centre, Sydney Children's Hospital, Randwick, Sydney, NSW 2031, Australia. (12) Department of Radiology, Hong Kong Children's Hospital, Hong Kong 999077, China. (13) Department of Oncology, Rambam Medical Center, Haifa 3109601, Israel. (14) Department of Pediatric Hematology-Oncology, Rambam Medical Center, Haifa 3109601, Israel.

Publication

Cancers (Basel)

Summary

Desmoid fibromatoses (DFs) are locally aggressive tumors composed of monoclonal fibroblasts within an abundant extracellular matrix. Systemic doxorubicin treatment is effective, but toxic. We investigated arterial doxorubicin eluting embolization (DEE), an approach characterized by high drug concentrations in the tumor alongside limited systemic drug exposure. The primary and secondary endpoints were radiological response using MRI and RECIST 1.1, respectively. The study included 24 patients (median age, 24; interquartile range, 16-34 years). Data were collected prospectively for 9 patients and retrospectively for 15 patients. The most frequent tumor locations were chest/abdomen wall and neck/shoulder/axilla (29% each). Of 24 patients, 7 (24%) were treatment naïve, and 17 (71%) had received one or two prior treatments. Patients underwent a median of two treatments (range, 1-4), with a median of 49 mg (range, 8-75) doxorubicin/treatment. Efficacy outcomes were available for 23 patients. With a median follow-up of 8 months (interquartile range, 3-13), median tumor volumes decreased by 59% (interquartile range, 40-71%) and T2 signal intensity decreased by 36% (interquartile range, 19-55%). Of 23 patients, 9 (39%), 12 (52%), and 2 (9%) had a partial response, stable disease, and progressive disease, respectively. DEE was safe and well tolerated, with one reported grade 3-4 adverse event (cord injury). In conclusion, DEE was safe and achieved rapid clinical/volumetric responses in DFs.

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