Nanoknife in SCC Esophagus?

Portal Forums Cancer Basics General Cancer Basics Nanoknife in SCC Esophagus?

This topic contains 3 replies, has 2 voices, and was last updated by catdander forum moderator catdander forum moderator 2 months, 4 weeks ago.

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April 29, 2017 at 12:51 pm  #1290665    
david49
david49

48y old woman (lives UK) diagnosed 20 months ago with T3N3M1 inoperable SCC mid esophagus. Deemed inoperable due to nodal disease of 24cm length. Underwent 6x EOX chemotherapy, followed by 6x Docetaxel (without serious complication.) Worsening dysphagia led to 10 fractions of palliative radiotherapy to primary lesion. Caused worsened dysphagia-resolved by 4 stretches.
Opted for Nivolumab immunotherapy, so far 13 infusions (at two-weekly intervals.) CT demonstrates progressive shrinkage of isolated pulmonary met. Primary lesion appears to be only 1cm in length; 5cm at diagnosis, but new, enlarged retro-crural and coeliac axis nodes (considered possible to be inflammatory effect of stretches +/- pseudo-progression, but could of course be disease.) Liver clear.
Patient very well, weight same, and no concurrent conditions.
My question: is there a possible role for Nanoknife (IRE)?

April 29, 2017 at 9:50 pm  #1290666    
catdander forum moderator
catdander forum moderator

Hi David,

Welcome to Grace. I’m sorry you’re dealing with this. There doesn’t appear to be any research data to say whether nanoknife is or isn’t beneficial as a treatment for esophageal cancer. Nor are there clinical trials outside one hospital in China which appears to be ongoing.

I hope you do well.
All best,
Janine

April 29, 2017 at 11:14 pm  #1290667    
david49
david49

Many thanks, Janine,
Patient is my dear wife. We’re naturally keen to seek all treatment as appropriate. Are delighted she’s receiving immunotherapy, inspired by Kojima’s paper, presented January 2016 re SCC esophagus http://meetinglibrary.asco.org/content/158885-173
I am keen to know if it is technically possible to use Nanoknife to a circumferential mid esophagus primary +/- lymph nodes, as described.
I discovered this trial at Guangzhou, China https://clinicaltrials.gov/ct2/show/NCT02430766 but are there any trials specific to esophagus?
Thanks again,

David

April 30, 2017 at 11:09 am  #1290669    
catdander forum moderator
catdander forum moderator

Thanks for clarifying. I know what’s it’s like to need to learn so much so fast. There’s the obvious desire that any treatment benefit and not harm. Unfortunately that’s not a factor often guaranteed (or even statistically probable) in cancer treatment and that’s with stringent study data and thoughtful oncology teams focused on an individual. With that said trying something that isn’t at all tested on such a delicate structure is risky.

Below is the link to the clinical trial I found on esophageal cancer. The intention of that trial is to determine the safety of using nanoknife on the esophagus. It’s probably possible to find someone who will use this technique on the esophagus outside a trial (the technology is expensive and needs to be paid for). However, without the watchful eye of a trial team it would be risky and without any knowledge that there’s a statistical benefit.

https://clinicaltrials.gov/ct2/show/NCT02430701?term=nanoknife&cond=esophageal+cancer&rank=1

I wish there was something more positive to say. I hope your wife does well with the immunotherapy treatments.
Best of luck and hopes,
Janine

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