{"doi":"10.3390/cancers17172880","title":"Pulmonary Suffusion Refinements for Primary and Secondary Malignancies: Preliminary Analyses of Phase I Safety and Drug Delivery Data","abstract":"Objectives: We sought to document interim methodologic improvements and preliminary results for pulmonary suffusion. Methods: A Phase I/II trial of thoracoscopic lung suffusion for resectable sarcoma and colorectal carcinoma metastases followed a pilot study on oligometastatic lung malignancy at a comprehensive cancer center. Primary-specific chemotherapy doses (cisplatin, oxaliplatin, doxorubicin, or gemcitabine) suffused unilaterally for 30 min were escalated to amplify regional deliveries three-fold. Drug delivery was measured with tissue, blood samples, and 99Tc; pulmonary function tests and clinical adverse events (AEs) assessed safety and tolerance. Results: From 2008–2025, 31 ECOG 0–2 patients (10 male) aged 33–75 years had unilateral lung suffusion (16 right, 14 left, 1 aborted, and 8 sides selected randomly). Vascular occlusion intolerance was immediate or delayed (25 min) in two cases. Two catheter-positioning grade 3 AEs occurred: hypotension with troponin leak (1) and atrial fibrillation (1). Patients averaged 1.3 ± 1.2 metastasectomies (17 sub-lobar, 8 lobar resections, and 2 intentional open cytoreductive metastasectomies). Hospitalizations were brief (1–4 days) except for 6–7 day stays in the only two open cases and one doxorubicin (grade 4 hypoxic respiratory failure) case. Ninety-day survival was 100%, and the Phase I delivery goal of 12.75 mg/m2 65 (15% systemic) was achieved for oxaliplatin. Lung function was preserved according to 99Tc differentials within 6.1 ± 7.1% of the predicted reductions at 30 days. Sampling delays, tracer discordances, and atypical pharmacokinetics reduced tissue drug detections. Recent pulmonary artery snaring cases (two) demonstrated in-flow control more stable than that of balloon occlusions. Conclusions: Suffusion for metastatic malignancies appears safe and warrants further investigation.","journal":"Cancers","year":2025,"id":573960,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9644,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1481477,"name":"Sawsan Abdel‐Hady","orcid":null,"position":1,"is_corresponding":false},{"id":1481478,"name":"Garin Tomaszewski","orcid":null,"position":2,"is_corresponding":false},{"id":1481479,"name":"Michael Petroziello","orcid":null,"position":3,"is_corresponding":false},{"id":850074,"name":"Omar Hasan","orcid":"0000-0002-3451-3299","position":4,"is_corresponding":false},{"id":1481480,"name":"Mark Hennon","orcid":null,"position":5,"is_corresponding":false},{"id":1276469,"name":"Elisabeth U. Dexter","orcid":"0000-0002-7554-9060","position":6,"is_corresponding":false},{"id":1089908,"name":"Deepak Vadehra","orcid":"0000-0002-1901-8222","position":7,"is_corresponding":false},{"id":1254752,"name":"Ajay Gupta","orcid":"0000-0001-6074-9847","position":8,"is_corresponding":false},{"id":1481481,"name":"Anne Grand‘Maison","orcid":null,"position":9,"is_corresponding":false},{"id":368989,"name":"Grace K. Dy","orcid":"0000-0002-5061-0072","position":10,"is_corresponding":false},{"id":958868,"name":"Sai Yendamuri","orcid":"0000-0001-6654-3487","position":11,"is_corresponding":false},{"id":1262077,"name":"Todd L. Demmy","orcid":"0000-0002-4800-2297","position":0,"is_corresponding":true}],"reference_count":37,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:57:36.753600Z","pmid":"40940977","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}