The efficacy of hydrogel foams in talc Pleurodesis

Malignant pleural effusions are a serious complication of many late stage cancers that adversely affect quality of life. Pleurodesis with talc slurry is a standard treatment option, but clinical failures occur, possible due to poor talc delivery. A novel drug-delivery system was developed that fills...

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Bibliographic Details
Published in:Journal of cardiothoracic surgery 2020-04, Vol.15 (1), p.58-58, Article 58
Main Authors: Baxter, Joy, Lima, Thamires A, Huneke, Richard, Kanach, Colin Joseph, Johal, Priya, Reimold, Emily, Alvarez, Nicolas J, Laub, Glenn W
Format: Article
Language:English
Subjects:
Adhesion
Adhesion formation
Analysis
Block copolymers
Body temperature
Copolymers
Drug delivery systems
Experiments
Foam delivery system
Foams
Gelation
Hydrogels
Laboratory animals
New Zealand rabbit model
Pediatrics
Phase transitions
Pleura
Quality of life
Rabbits
Rheological properties
Rheology
Slurries
Talc
Talc pleurodesis
Thorax
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Summary:Malignant pleural effusions are a serious complication of many late stage cancers that adversely affect quality of life. Pleurodesis with talc slurry is a standard treatment option, but clinical failures occur, possible due to poor talc delivery. A novel drug-delivery system was developed that fills the entire thoracic cavity with a liquid foam containing talc. The foam is designed to gel and adhere to the tissue walls at body temperature, to improve talc deposition and efficacy. Rheology, foam stability, and ex-vivo coating and bio-adhesion studies were performed on three concentrations of a novel hydrogel talc foam system that was developed to improve delivery of talc to the pleural surfaces. A New Zealand rabbit model of pleurodesis was used to evaluate effectiveness of the foams at inducing adhesion formation and compared to talc slurry. The rabbits were recovered after they had one of the test agents instilled into their pleura, and then sacrificed after 28 days. Pleurodesis was assessed by a blinded pathologist using a standardized pathological scoring system. All talc foam formulations produced foams that gelled at physiological temperatures and were relatively stable for at least two hours. As the concentration of the formulation increased the gelation temperature decreased and the foam adhesiveness increased. Rabbits that received talc foam had significantly greater adhesion formation than talc slurry (mean score of 2.21 vs. 1.18 (p 
ISSN:1749-8090
1749-8090
DOI:10.1186/s13019-020-01098-y