Proxcelan Cesium-131 (cesium-131) / Boston Scientific, Perspective Therap - LARVOL DELTA

Redefining bladder neck dose in low-dose-rate prostate brachytherapy-Can we improve urinary toxicity without impacting disease control? (PubMed, Brachytherapy) - "BND has a significant impact on both acute and chronic urinary symptoms, with reduced symptoms reported with BND <70% of prescription dose. With a median follow up of 4.7 years, excellent bDFS has thus far been achieved with relative urethral and bladder neck sparing. Utilizing this constraint should improve urinary symptoms without impacting disease control."

Journal • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Perspective Therapeutics’ Cesium-131 Featured at the American Society for Radiation Oncology’s Annual Conference (GlobeNewswire) - "Perspective Therapeutics, Inc...announced that long-term data regarding Cesium-131 brachytherapy in the treatment of prostate cancer, as well as preliminary long-term data of Cesium-131 utilized in salvage treatment of recurrent cervical and uterine cancers were presented at the American Society for Radiation Oncology’s (ASTRO) Annual Conference held in San Diego, from October 1-4, 2023. The first presentation...was presented by Mohamed Abdelhakiem, MD from the UPMC Hillman Cancer Center in Pittsburgh, PA. The presentation described urinary data collected from 341 patients treated with Cesium-131 between 2006 and 2022....The aim of the study was to report local cancer control rates and the toxicity profile of Cesium-131 brachytherapy as a salvage re-irradiation option for patients with recurrent disease. The authors concluded that Cesium-131 brachytherapy is a promising alternative to pelvic exenteration, which can be a significant surgical procedure."

Clinical data • Cervical Cancer • Genito-urinary Cancer • Gynecologic Cancers • Oncology • Prostate Cancer • Solid Tumor • Uterine Cancer

Long-Term Urinary Toxicity Follow-Up of Combined External Beam Radiation and Cs-131 LDR Brachytherapy Boost for Prostate Cancer. (PubMed, Int J Radiat Oncol Biol Phys) - "Long-term patient-reported clinically significant decreases in urinary function and urinary incontinence mean EPIC scores occurred up to 18 months following combined external beam radiation and Cs-131 prostate brachytherapy and returned to baseline at 24 months, while clinically significant decrease in urinary irritability/obstructive mean scores occurred at 9 months and returned to baseline at 12 months. At 42 months follow-up, mean urinary domain scores improved from pre-treatment baseline in 15-30% of patients."

Journal • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor • Urinary Incontinence • Urology

Long-Term Urinary Toxicity Follow-Up of Combined External Beam Radiation and Cs-131 LDR Brachytherapy Boost for Prostate Cancer (ASTRO 2023) - "Long-term patient-reported clinically significant decreases in urinary function and urinary incontinence mean EPIC scores occurred up to 18 months following combined external beam radiation and Cs-131 prostate brachytherapy and returned to baseline at 24 months, while clinically significant decrease in urinary irritability/obstructive mean scores occurred at 9 months and returned to baseline at 12 months. At 42 months follow-up, mean urinary domain scores improved from pre-treatment baseline in 15-30% of patients."

Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor • Urinary Incontinence • Urology

Outcomes of Brain Metastases with Suspicious Imaging Undergoing Resection to Evaluate for Radionecrosis vs. Tumor Progression (ASTRO 2023) - "We recommend cautious monitoring of possible progression after radiosurgery, with consideration of resection for continuous progression, as a significant proportion of radiographic progression are ultimately pure RN. Management determined by pathology (observation for RN; additional radiation for confirmed tumor) leads to excellent control."

Lung Cancer • Melanoma • Non Small Cell Lung Cancer • Oncology • Solid Tumor

Cesium-131 Low-Dose Rate Interstitial Brachytherapy as a Salvage Re-Irradiation Technique in Treating Cervical and Uterine Cancer Pelvic Recurrence with Prior History of Pelvic Radiation (ASTRO 2023) - "Cesium-131 LDR interstitial brachytherapy is a safe and feasible salvage re-irradiation technique in treating pelvic relapse among uterine corpus or cervix cancer patients with prior history of pelvic radiation. Local control rate at 6-months was acceptable with minimum toxicity. Long-term follow up is warranted to validate the efficacy of cesium-131 LDR."

Cervical Cancer • Gynecology • Mucositis • Oncology • Pain • Solid Tumor • Uterine Cancer

Cesium-131 Low-Dose Rate Interstitial Brachytherapy as a Salvage Re-Irradiation Technique in Treating Cervical and Uterine Cancer Pelvic Recurrence with Prior History of Pelvic Radiation. (PubMed, Int J Radiat Oncol Biol Phys) - "Cesium-131 LDR interstitial brachytherapy is a safe and feasible salvage re-irradiation technique in treating pelvic relapse among uterine corpus or cervix cancer patients with prior history of pelvic radiation. Local control rate at 6-months was acceptable with minimum toxicity. Long-term follow up is warranted to validate the efficacy of cesium-131 LDR. We conclude that cesium-131 LDR interstitial brachytherapy is a promising alternative to pelvic exenteration in selective patient population. Future prospective study is warranted."

Journal • Cervical Cancer • Gynecology • Mucositis • Oncology • Pain • Solid Tumor • Uterine Cancer

Outcomes of Brain Metastases with Suspicious Imaging Undergoing Resection to Evaluate for Radionecrosis vs. Tumor Progression. (PubMed, Int J Radiat Oncol Biol Phys) - "We recommend cautious monitoring of possible progression after radiosurgery, with consideration of resection for continuous progression, as a significant proportion of radiographic progression are ultimately pure RN. Management determined by pathology (observation for RN; additional radiation for confirmed tumor) leads to excellent control."

Journal • Lung Cancer • Melanoma • Non Small Cell Lung Cancer • Oncology • Solid Tumor

Surgical Resection and Intraoperative Cesium-131 Brachytherapy for Head and Neck Cancer (clinicaltrials.gov) - P1 | N=30 | Completed | Sponsor: Sidney Kimmel Cancer Center at Thomas Jefferson University | Active, not recruiting ➔ Completed

Trial completion • Head and Neck Cancer • Oncology • Solid Tumor

Safety and efficacy of Cesium-131 brachytherapy for brain tumors. (PubMed, J Neurooncol) - "Cs-131 brachytherapy demonstrated a favorable safety and efficacy profile characterized by high rates of local control for all treated pathologies. The concept of brachytherapy has seen a resurgence given the excellent results when Cs-131 is used as a source."

Journal • Brain Cancer • CNS Tumor • Glioma • Lung Cancer • Meningioma • Non Small Cell Lung Cancer • Oncology • Solid Tumor

Permanent carrier-embedded cesium-131 brachytherapy for the salvage treatment of previously irradiated, recurrent brain metastases (SNO 2022) - P2 | "With >1 year of follow-up, intraoperative brachytherapy with Cs131 implants was associated with a high rate of local control and a favorable toxicity profile. Modest correlation between preoperative tumor geometry and implanted tiles with high associated cost suggests a need to optimize planning criteria. A randomized trial of salvage resection with or without Cs131 is ongoing (NCT04690348) to assess the incremental benefit of brachytherapy."

CNS Disorders • Oncology • Solid Tumor • Ventriculomegaly

Cesium-131 brachytherapy for the treatment of brain metastases: Current status and future perspectives. (PubMed, J Clin Neurosci) - "Further analyses have demonstrated superior cost-effectiveness and quality-of-life improvement ratios of cesium-131 brachytherapy than adjuvant stereotactic radiosurgery. Cesium-131 brachytherapy is a safe and effective post-surgical treatment option for brain metastases with associated clinical and cost-effectiveness benefits in appropriately selected patients."

Journal • Review • Oncology • Solid Tumor

Safety and efficacy of salvage therapy with laser interstitial thermal therapy for malignant meningioma refractory to cesium-131 brachytherapy: illustrative case. (PubMed, J Neurosurg Case Lessons) - "The use of LITT in combination with brachytherapy remains an option for salvage therapy in patients with recurrent meningioma that provides durable local control of tumor."

Journal • Brain Cancer • CNS Tumor • Meningioma • Oncology • Solid Tumor • Thermal Injury

Feasibility of collagen matrix tiles with cesium-131 brachytherapy for use in the treatment of head and neck cancer. (PubMed, Brachytherapy) - "We present a feasibility and concept cadaveric study using a collagen matrix with Cesium-131 demonstrating preliminary evidence to support its ease of use, decreased time to implantation, and decreased dose delivered to the carotid artery."

Journal • Head and Neck Cancer • Oncology • Otorhinolaryngology • Solid Tumor

Safety and patterns of survivorship in recurrent GBM following resection and surgically targeted radiation therapy: Results from a prospective trial. (PubMed, Neuro Oncol) - "This pre-commercial trial demonstrated acceptable safety and favorable post-treatment local control and survival. The device has received FDA clearance for use in newly diagnosed malignant and all recurrent intracranial neoplasms."

Journal • Brain Cancer • Cerebral Hemorrhage • CNS Disorders • CNS Tumor • Glioblastoma • Hematological Disorders • Immunology • Infectious Disease • Oncology • Solid Tumor • Vascular Neurology • MGMT

Toxicity Outcomes at 18 Months for Cs-131 Low-Dose-Rate Prostate Brachytherapy Compared to I-125 and Pd-103 (ASTRO 2022) - "In patients treated with Cs-131 or Pd-103 LDRB, acute GU side effects peaked higher at 1 month than with I-125, but rapidly decreased to similar levels with longer follow-up. The type of source used did not predict for need for catheterization, ED, or GI toxicity at any time point. Cs-131 I-125 Pd-103 P value Mean AUA Score Pretreatment 6.1 5.8 7.8 1.00 1 month 20.1 13.4 19.2 <0.001 7 month 8.8 11.1 11.1 0.968 18 month 8.4 10.0 11.6 1.00"

Erectile Dysfunction • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Patient-specific dose correction for prostate postimplant evaluation with flexible timing of postimplant imaging. (PubMed, Med Phys) - "The postimplant dose calculation based on the proposed inverse power law for prostate seed implants with edema has improved the accuracy of postimplant dosimetry with accurate and patient-specific dose corrections accounting for prostate size, edema half-life, and postimplant imaging times. Optimal times for postimplant imaging have been accurately determined, and high accuracy of postimplant dose calculation can be achieved for both optimal imaging times and non-optimal imaging times."

Journal

Prospective Evaluation of Focal Brachytherapy Using Cesium-131 For Patients With Low Risk Prostate Cancer (clinicaltrials.gov) - P=N/A | N=0 | Withdrawn | Sponsor: Ronald M. Benoit, MD | N=100 ➔ 0 | Trial completion date: Feb 2022 ➔ Jul 2022 | Recruiting ➔ Withdrawn | Trial primary completion date: Feb 2022 ➔ Jul 2022

Enrollment change • Trial completion date • Trial primary completion date • Trial withdrawal • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Salvage resection plus cesium-131 brachytherapy durably controls post-SRS recurrent brain metastases. (PubMed, J Neurooncol) - "With > 1.5 years of follow-up, intraoperative brachytherapy with commercially available Cs131 implants was associated with favorable local control and toxicity profiles. Weak correlation between preoperative tumor geometry and implanted tiles highlights a need to optimize planning criteria."

Journal • Brain Cancer • Oncology • Solid Tumor

Dosimetric Impacts of Source Migration, Radioisotope Type, and Decay with Permanent Implantable Collagen Tile Brachytherapy for Brain Tumors. (PubMed, Technol Cancer Res Treat) - P=N/A | "Intratarget heterogeneity was greater with Pd-103 and I-125 than Cs-131. Dose fall-off was fastest with Pd-103 followed by I-125 and then Cs-131."

Clinical • Journal • Retrospective data • Brain Cancer • Glioblastoma • Immunology • Oncology • Solid Tumor

The role of cesium-131 brachytherapy in brain tumors: a scoping review of the literature and ongoing clinical trials. (PubMed, J Neurooncol) - "Initial data suggest that cesium-131 brachytherapy is safe and effective in primary or metastatic malignant brain tumors. Ongoing trials are evaluating long-term locoregional tumor control and future studies should analyze its role in multimodal systemic tumor management."

Journal • Review • Brain Cancer • CNS Disorders • Epilepsy • Glioma • Infectious Disease • Meningioma • Oncology • Solid Tumor

Effect of short-term corticosteroid usage on acute urinary toxicity following Cs-131 prostate brachytherapy. (PubMed, Brachytherapy) - "A short course of perioperative low-dose prednisone was associated with less severe worsening in urinary symptoms by the EPIC questionnaire at the 0.5-1.0-month timepoint suggesting some improvement in acute urinary quality of life, although differences did not remain statistically significant at 3 months."

Journal • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

[VIRTUAL] Virtual Hands-on Training of Image-guided Urologic Procedures During the COVID-19 Pandemic (AUA 2021) - "This was the first demonstration of remote learning on a physical prostate phantom. While the faculty had more confidence that 30 minutes training was adequate, the attendees requested their own phantom for training. The Covid-19 pandemic provided the opportunity to introduction a novel training approach."

Infectious Disease • Novel Coronavirus Disease • Oncology • Urology • MRI

Resection with intraoperative cesium-131 brachytherapy as salvage therapy for recurrent brain tumors. (PubMed, J Neurosurg) - "Cesium-131 brachytherapy resulted in good local control and acceptable rates of symptomatic AREs and surgical complications in this heavily pretreated cohort, and it may be a reasonable salvage adjuvant treatment for this patient population."

Journal • Brain Cancer • Immunology • Meningioma • Oncology • Solid Tumor

Multimodality durable salvage of recurrent brain metastases refractory to LITT, SRS and immunotherapy with resection and cesium-131 brachytherapy: case report and literature review. (PubMed, BMJ Case Rep) - "The patient's disease remained stable through 18 months postoperatively. This case illustrates the range of options available and provides a combination salvage therapy strategy in a select group of locally recurrent patients who have exhausted conventional treatment options."

Clinical • Journal • Review • Brain Cancer • CNS Tumor • Genito-urinary Cancer • Oncology • Renal Cell Carcinoma • Solid Tumor