by Ellen Heirwegh

Pleural mesothelioma (PM) is a highly aggressive cancer primarily caused by historical asbestos exposure. The disease is often diagnosed at an advanced stage, limiting treatment options, and resulting in a poor prognosis. Current therapies, including the combination of immune checkpoint inhibitors ipilimumab and nivolumab, have demonstrated improved overall survival, extending it by approximately four months compared to cisplatin and pemetrexed, which provide only 2-3 months of survival benefit. Despite this improvement, response rates to the immunotherapy regimen remain low, and the treatment can cause significant toxicity while increasing healthcare costs.

Using ion mobility spectrometry (IMS), we have shown the ability to predict therapy response by analysing volatile organic compounds (VOCs) in exhaled breath. Building on these findings, the INSPIRATIONAL project aims to investigate the underlying factors that dictate therapy response, and the role of the tumour microenvironment (TME).

by Erik Claes

Lung cancer is one of the most common types of cancer and remains the leading cause of cancer-related deaths worldwide. Unfortunately, lung tumors are often diagnosed at an advanced stage, where therapeutic options are limited to a multimodal therapy, including chemotherapy, radiotherapy and/or immunotherapy. Conventional treatments, such as intravenous chemotherapy, often face dose limitations due to the occurrence of systemic toxicities, which can lead to suboptimal lung concentrations and thus reduce the effectiveness against micrometastases.

To resolve this issue, locoregional administration techniques, like selective pulmonary artery perfusion with blood flow occlusion (SPAP-BFO), are in development. These techniques aim to increase local drug levels while reducing the systemic exposure. SPAP-BFO is an experimental endovascular approach designed to prolong the exposure of a cytostatic agent in the lung by partially or fully occluding the blood flow within one of the pulmonary arteries. This procedure requires catheterization of a vein to allow the introduction of a balloon catheter, which is then positioned in the pulmonary artery. Subsequently, the balloon is inflated to occlude the vessel after which the cytostatic agent can be injected through its lumen.

In our study, we compared the pharmacokinetics of gemcitabine delivered via SPAP-BFO with the standard intravenous administration utilizing a pig model. Within this model, we also assessed the procedure’s safety by monitoring physiological and hemodynamic parameters and examining the lungs for injuries (through histology and ex-vivo imaging). Additionally, we studied the clinical feasibility of the catheterization procedure of SPAP-BFO using a realistic 3D model of the human venous system. By studying these different aspects, we aim to bridge the gap between the preclinical studies and the clinical application.

by Allegra Ferrari

Abstract