SMANCS/Lipiodol

T. Konno and H. Maeda, Targeting chemotherapy of hepatocellular carcinoma Arterial administration of SMANCS/Lipiodol, in Neoplasm in the Liver (K. Okada and K. G. Ishak, eds.), Springer-Verlag, New York, 1987, p. 343. 

Koimo T, Maeda H. Targeting chemotherapy of hepatocellular carcinoma arterial administration of SMANCS/Lipiodol. In Okada K, Ishak KG, eds. Neoplasm in the Liver. New York Springer-Verlag, 1987 343. 

Konno, T. and Maeda, H. (1987) Targeting chemotherapy of hepatocellular carcinoma arterial administration of smancs/lipiodol. In Okuda, K. and Ishak, K.G. (eds). Neoplasms of the Liver, pp. 343-352, chap. 27. Sptinger-Verlag, New York. 

Fig. 2 EPR effect and drug accumulation in solid tumor. (A) and (B) CT scan of human liver with hepatocellular carcinoma. When SMANCS/Lipiodol was infused arterially it was selectively taken up in the tumor. CT scan of (A) was obtained 2 days after the initial arterial infusion via a catheter, in which SMANCS/Lipiodol was selectively accumulated in the massive carcinoma seen as white area in the liver (due to high electron density of Lipiodol ). After 6 months with intermitted infusions of SMANCS two more times, tumor size (containing SMANCS) has remarkably regressed (B). (C) EPR effect in mouse sarcoma S-180 in mouse skin. Two dark blue circular areas are tumors marked by 0, where putative macro-molecular drug, Evans blue/albumin (MW 70 kDa), accumulated selectively. Note that the background of the normal skin shows no uptake of blue albumin. Mouse was killed at 6 h after the injection of Evans blue and it was quantified after extraction...

We found that the NO-releasing agent isosorbide dinitrate (ISDN, Nitrol ) enhanced antitumor activity of SMANCS/Lipiodol when they were infused into the tumor-feeding bronchial artery of lung cancer using a catheter preceding to the infusion of SMANCS arterially. This ISDN infusion enhanced... 

SMANCS/Lipiodol, approved in Japan 1993 for treatment of liver cancer, is administered via a catheter according to Seldinger s method into a tumor-... 

Table 2 Side effects of intra-arterial SMANCS/Lipiodol therapy in patients with hepatoma ...

Treatment of primary hepatoma by the SMANCS/Lipiodol method has been approved in Japan for more than 6 years, since 1995. When the drug is dehvered by intraarterial administration using catheter, this treatment produces definite tumor size reduction (in >90% of cases), improved survival scores, and especially a good quality of life with very little side effect (Table 4). Furthermore, patients can be out of bed within a few days after the procedure (the Seldinger method is used for arterial infusion under the X-ray system). For all cases of primary hepatoma combined (including Child s criteria of A-C cirrhosis), the 5- to 7- year survival rate is about 30% with this method. With other treatments, no survival would be expected during this time frame. Hepatoma patients with milder liver cirrhosis (such... 

Side effects of SMANCS/Lipiodol, when used via the intraarterial route for hepatoma patients, are summarized in Table 4. The major side effect is a low-grade fever, which depends on the procedural technique as well as on the individual patient, namely, some of which may also be due to the immunological host response. If the dose is appropriate, there seems to be little liver toxicity, although many, if not all, liver cancer patients have liver cirrhosis and tend to deteriorate progressively. There seems to be no fatal issue with this therapy. 

Kuruppu, D., Christophi, C., Maeda, H., and O Brien, P. E., 2002, Changes in the microvascular architecture of colorectal Uver metastases following the administration of SMANCS/lipiodol.7. Surg. Res. 103 47-54. 

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