EUS Guided Anti Tumor Therapyversion0

EUS Guided Anti-Tumor Therapy: Past, Present and Future Shivakumar Vignesh, MD Endoscopic Oncologist Moffitt Cancer Center

Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Therapeutic Capabilities of EUS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

E ndoscopic M ucosal R esection ,[object Object],[object Object],[object Object],[object Object],[object Object],T1 sm3 T1m1

EUS-guided Biliary and Pancreatic drainage EUS-Pancreatic drainage EUS-Biliary Drainage ,[object Object],[object Object],[object Object],[object Object]

EUS-guided Celiac Plexus Neurolysis For Unresectable Pancreatic Cancer ,[object Object],[object Object],[object Object],[object Object],[object Object],Fenestrated Needle

Rationale for Local Anti-tumor therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Agents Used for EUS-Guided Ablation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EUS-FNI for Cystic Pancreatic Tumors (CPT) ,[object Object],[object Object],[object Object],[object Object],[object Object]

EUS-FNI for CPT in Humans ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EUS Guided Ethanol Injection for Ablation of Mucinous Cysts

EUS-FNI Of TNFerade™ For Pancreatic Cancer Chang KJ et al . (2008) Endoscopic ultrasound delivery of an antitumor agent to treat a case of pancreatic cancer Nat Clin Pract Gastroenterol Hepatol 5: 107–111 doi:10.1038/ncpgasthep1033 Pancreatic mass shrinking with ► injections of TNFerade EUS-FNA negative 1 month after therapy EUS-FNI of TNFerade

EUS-FNI TNFerade: Result in 1 patient Resected pancreas with no residual tumor Chang KJ et al . (2008) Endoscopic ultrasound delivery of an antitumor agent to treat a case of pancreatic cancer. Nat Clin Pract Gastroenterol Hepatol 5: 107–111 doi:10.1038/ncpgasthep1033 Tumor measurements relative to weeks of TNFerade TM treatment Complete pathologic response ,[object Object],[object Object]

Phase 2/3, Randomized, Trial using TNFerade™ Combined with Chemoradiation in Locally Advanced Pancreatic Cancer Data presented at the ASCO 2007 meeting ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Image Guided Radiotherapy: EUS-Guided Fiducial Placement ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EUS-Guided Fiducial Placement: Esophageal Cancer

EUS-Guided Fiducial Placement: Rectal Cancer

EUS-guided Interstitial Brachytherapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EUS Guided Angiotherapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EUS-Guided Radiofrequency Ablation (RFA) and Photodynamic Therapy (PDT) ,[object Object],[object Object],[object Object],[object Object]

High Intensity Focused Ultrasound (HIFU) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Interventional EUS: Future possibilities ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EUS Guided Anti Tumor Therapyversion0

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