picibanil (OK-432) / Roche - LARVOL DELTA

Difference in structural and function alteration of pleural lymphatic and blood vessels by pleurodesis agents in mouse (ERS 2026) - "OK-432 offers a superior profile for pleural effusion absorption relative to minocycline and talc. A comprehensive understanding of these pharmacological properties may be crucial for optimizing the management and treatment of pleural effusions."

Preclinical • Respiratory Diseases • CD31 • CDH5 • LYVE1 • PECAM1

Comparative Evaluation of Kit-M (GM-CSF and PGE-1) and Kit-I (GM-CSF and Picibanil) for the Generation of DCs/DCleus and Their Impact on Subsequent Antileukemic Immune Cell Activation Ex Vivo. (PubMed, Cancers (Basel)) - " We show that Kit-M and Kit-I produce DCs/DCleus and subsequently enhance (potentially via a different mode of action) antileukemic immune cell activation after MLC. Our findings point to a possibility to enhance antileukemic treatment in vivo by combining agents or identifying criteria for selecting an appropriate agent (combination) for the respective patient in the course of a personalized treatment strategy."

Journal • Preclinical • Acute Myelogenous Leukemia • Hematological Malignancies • Leukemia • Oncology • CD4 • CSF2 • IFNG

Intraperitoneal OK-432 infusion for postoperative lymphatic leakage in gynecologic tumors. (PubMed, Gynecol Oncol Rep) - "Intraperitoneal OK-432 perfusion is a safe and effective treatment for postoperative lymphatic leakage following gynecologic tumor surgery. It may shorten drainage duration, avoids reoperation, and may offer a therapeutic alternative to current treatments for postoperative lymphatic leakage."

Journal • Gynecologic Cancers • Gynecology • Musculoskeletal Pain • Oncology • Pain

OK-432 sclerotherapy for a plunging ranula extending into the parapharyngeal space. (PubMed, J Dent Sci) - No abstract available

Journal

Sirolimus and Staged OK-432 Sclerotherapy for Airway-Compromising Cervicofacial Lymphatic Malformation in a Neonate. (PubMed, Pediatr Int) - No abstract available

Journal

Impact of CD73/CD155 Expression on Survival in Resected Epithelial Pleural Mesothelioma: A Retrospective Single-center Study. (PubMed, In Vivo) - "CD155 may serve as a poor prognostic factor in mesothelioma and represents the first immunohistochemical evaluation of this marker. Although CD73 and CD155 co-expression were initially predicted to indicate poor prognosis, findings were unexpected, likely due to inability to establish an optimal cutoff value given variations in patient demographics, disease stage, and treatment approaches."

IO biomarker • Journal • Retrospective data • Malignant Pleural Mesothelioma • Mesothelioma • Oncology • Pleural Mesothelioma • Solid Tumor • CD73 • PVR

A case in which OK-432 injection therapy was effective in treating persistent seroma after partial mastectomy, thus avoiding reoperation. (JBCS 2026) - "This treatment is minimally invasive and is considered to be an effective treatment option for refractory seromas after partial mastectomy. [Conclusion] We experienced a case in which intracavitary injection of OK-432 was effective for a refractory seroma after partial mastectomy and contributed to avoiding surgery."

Clinical • Breast Cancer • HER2 Breast Cancer • HER2 Negative Breast Cancer • HER2 Positive Breast Cancer • Hormone Receptor Positive Breast Cancer • Solid Tumor • ER • HER-2

Efficacy of intraoperative topical Sapylin (OK-432) for preventing lymph leakage following inguinal lymph node dissection in melanoma: a retrospective cohort study. (PubMed, BMC Surg) - P=N/A | "Intraoperative topical Sapylin is safe and effective for reducing postoperative lymphatic leakage and accelerating recovery after inguinal lymph node dissection for melanoma."

Journal • Retrospective data • Review • Infectious Disease • Melanoma • Oncology • Solid Tumor

Successful Treatment of Lymphocele after Inguinal Lymph Node Dissection with OK-432 Sclerotherapy: A Report of Two Cases. (PubMed, J Plast Reconstr Surg) - "Both cases showed mild dermal back flow on lymphoscintigraphy several years after surgery. Sclerotherapy with OK-432 resulted in acceptable results."

Journal

Comments to "Successful Treatment of Lymphocele After Inguinal Lymph Node Dissection with OK-432 Sclerotherapy: A Report of Two Cases". (PubMed, J Plast Reconstr Surg) - No abstract available

Journal

Simultaneous activation of innate immune suppressive components impairs antitumor efficacy of immunotherapy against the innate immune system (AACR 2024) - "We then employed OK-432, which reportedly stimulates TLR-2, TLR-4, and/or TLR-9, as OK-432 is widely used in Japan in the clinic...Taken together, we propose that successful combination treatment stimulating innate immunity against immunogenically cold cancers requires controlling the unwanted co-activation of innate immune suppressive cells. This study clearly demonstrates the mechanism of acquired resistance after administration of reagents that activate innate immunity, such as TLR agonists or STING agonists, and provides the basis for future successful combination therapy."

Clinical • Oncology • CXCL1 • CXCR2 • TLR4 • TLR9

Identifying the mechanism of acquired resistance against cancer immunotherapy targeting innate immunity (AACR 2025) - "Thus, we argue that stimulators of innate immunity, such as TLR agonists including OK-432, are a double-edged sword. A stimulator of innate immunity may become an effective cancer immunotherapy by controlling the acquired resistance mechanism, namely, the activation of innate immune suppressive cells in the TME."

IO biomarker • Preclinical • Oncology • CD8 • CXCL1 • CXCR2 • PTPRC • TLR2 • TLR4 • TLR9

Systematic Review and Meta-Analysis of the Management and Outcomes of Recurrent Ranulas. (PubMed, Oral Dis) - "Sublingual gland excision was consistently associated with the lowest recurrence rates, while outcomes following marsupialization and sclerotherapy varied by technique and agent."

Journal • Retrospective data • Review

Postoperative pleurodesis using OK-432 for pulmonary air leak in lung cancer patients with idiopathic interstitial pneumonia: A retrospective study. (PubMed, Surg Today) - "There were no treatment-related deaths following OK-432 pleurodesis in IIP patients; however, IIP remained a significant risk factor for pleurodesis-related complications, particularly pneumonia. Early intervention and elevated WBC levels may increase the complication risk. Delaying pleurodesis until the WBC count normalizes is advisable to reduce adverse events."

Journal • Retrospective data • Infectious Disease • Interstitial Lung Disease • Lung Cancer • Oncology • Pneumonia • Respiratory Diseases • Solid Tumor

Percutaneous Sclerotherapy of Postoperative Lymphoceles: A Systematic Review and Meta-analysis of Different Sclerosant Agents. (PubMed, Cardiovasc Intervent Radiol) - "Percutaneous sclerotherapy yielded favorable results with all agents; however, ethanol is the best-characterized agent, with consistent outcomes and moderate certainty of evidence. High-quality, prospective research is needed in order to choose the best sclerosant agent and standardize the procedure."

Journal • Retrospective data

A Stepwise Integrative Approach to Managing a Refractory Recurrent Cervical Sialocele in a Dog. (PubMed, Animals (Basel)) - "Oral phenobarbital was instituted, resulting in partial reduction in fluid accumulation and improved comfort. To the authors' knowledge, this is the first report describing intracavitary OK-432 sclerotherapy as part of a staged multimodal strategy for canine cervical sialocele. This case illustrates the feasibility of integrating medical salivary suppression and minimally invasive sclerotherapy as bridging measures before salvage VPM surgery for refractory cervical sialocele."

Journal • Fibrosis

Strategies to prevent seroma formation after mastectomy surgery: A systematic review and meta-analysis. (PubMed, JPRAS Open) - "Steroids and selected adjuncts (OK-432, hemostatic powders, diuretics) were associated with a 59 % reduction in seroma incidence (pooled OR 0.41, 95 % CI: 0.26-0.64, I² = 36 %). Routine use of tissue adhesives, harmonic scalpel, or nitroglycerin ointment is not supported by current evidence. Future research should focus on standardized outcome reporting and direct comparisons of effective strategies, particularly in the setting of mastectomy reconstruction."

Journal • Retrospective data • Review

Surgical Technique for Recurrence after Pleurodesis in Patients with Pneumothorax Complicated by Chronic Obstructive Pulmonary Disease (APSR 2025) - "Case Report : A 60-year-old man with a history of surgery and pleurodesis with OK-432 for secondary pneumothorax due to COPD was referred to our department for treatment of recurrent pneumothorax...Although bronchoscopic treatment with the endobronchial spigot is an option, filling the upper lobe bronchus is technically not easy. This surgical method of using the bulla wall, fibrin glue, and PGA sheets is useful in patients with intractable pneumothorax."

Clinical • Chronic Obstructive Pulmonary Disease • Immunology • Infectious Disease • Interstitial Lung Disease • Pneumonia • Pulmonary Disease • Respiratory Diseases

Association between pleurodesis before immunotherapy and pneumonitis in non-small cell lung cancer. (PubMed, Respir Investig) - "Pleurodesis before immunotherapy in patients with advanced non-small cell lung cancer was associated with an increased incidence of pneumonitis."

Journal • Lung Cancer • Non Small Cell Lung Cancer • Oncology • Pneumonia • Respiratory Diseases • Solid Tumor

Advances in sclerosants for low-flow vascular malformations. (PubMed, Ann Vasc Surg) - "This review summarizes the sclerosants presently employed for LFVMs and suggests that the sclerotherapy approach must be personalized, taking into comprehensive account the specific type of LFVM, anatomical location, patient factors, and so on. Future high-quality clinical studies are needed to compare the efficacy and safety of these agents and to identify the most suitable sclerosants for specific vascular abnormalities."

Journal • Review

Enhanced efficacy of immune checkpoint inhibitors with OK-432 in malignant pleural mesothelioma: A case report. (PubMed, Mol Clin Oncol) - "Although immunotherapy with ipilimumab (IPI) and nivolumab (NIVO) has the potential to improve outcomes, disease progression, including recurrent pleural effusions, often occurs during or after the initial treatment. These findings suggested that OK-432 may modulate immune responses and potentially enhance the efficacy of ICIs. Further studies are warranted to validate the synergistic potential of OK-432 and ICIs in MPM and other thoracic malignancies."

Checkpoint inhibition • Journal • Malignant Pleural Mesothelioma • Mesothelioma • Oncology • Pleural Mesothelioma • Respiratory Diseases • Solid Tumor • Thoracic Cancer

Refractory Ranula Following Surgery for Tongue Cancer: A Case Report. (PubMed, Cureus) - "Our case revealed that sclerotherapy with OK-432 is not effective for ranula, which is a postoperative complication of tongue cancer. In such cases, surgical treatments such as marsupialization may be appropriate."

Journal • Anesthesia • Oncology • Oral Cancer • Tongue Carcinoma

Orbital venous lymphatic malformations: case series on minimally invasive treatment approach. (PubMed, Rom J Ophthalmol) - "Medical management involves injecting sclerosant into the cystic areas of the lesion, resulting in shrinkage and collapse, followed by total excision, which is the most suitable treatment option. The authors present a series of cases in which lymphangiomas have been completely excised using this minimal manipulative approach."

Journal • Hematological Disorders • Ocular Inflammation • Ophthalmology • Optic Neuritis • Pain • Pediatrics

Effect of OK-432 pleurodesis on long-term survival outcomes after pulmonary lobectomy for lung cancer patients: a retrospective case-control study. (PubMed, J Thorac Dis) - "These findings confirm the utility of OK-432 in addressing immediate postoperative challenges but do not support its use as a prognostic factor in the long-term management of lung cancer. Further investigation is necessary to explore the full spectrum of OK-432's biological effects and potential benefits in a broader oncological context."

Journal • Retrospective data • Lung Cancer • Non Small Cell Lung Cancer • Oncology • Respiratory Diseases • Solid Tumor

OK-432 (Picibanil) Sclerotherapy for the Treatment of Chyle Leakage After Thyroid Surgery. (PubMed, Korean J Radiol) - "Picibanil sclerotherapy may be a safe and effective treatment for chyle leakage after thyroid surgery. It may offer a minimally invasive alternative with a high clinical success rate and minor, manageable adverse effects."

Journal • Pain