1. Field of the Invention
The present invention pertains to the treatment of cancer, such as, without limitation, bladder cancer, including intravesical treatment of bladder cancer, and, in particular, to a system and method for delivering cancer treating agents (e.g., chemotherapeutic and immunotherapeutic agents) to the an organ such as the bladder.
2. Description of the Related Art
Each year multiple thousands of people are diagnosed with bladder cancer. Furthermore, bladder cancer remains one of the most expensive malignancies worldwide in terms of the cost incurred in making a diagnosis and in its subsequent treatment, due in large part to the diagnostic tests and treatments (surgical and non-surgical) patients are required to undergo in the management of this disease.
Roughly 70% of new bladder cancer cases are what is known as transitional cell bladder cancer, also referred to as superficial bladder cancer, wherein the cancer has not penetrated the bladder wall. Patients with superficial bladder cancer are often at increased risk of developing subsequent tumors such that in many cases, multiple surgeries and/or chemotherapy and/or immunotherapy treatments are required. Also, the recurrence rate for bladder cancer is estimated to be between 50% and 70%, with as much as fifteen years between the initial diagnosis and the second occurrence.
The standard of care for transitional cell bladder cancer is a treatment known as intravesical therapy. In intravesical therapy, the doctor uses a catheter to deliver a liquid agent, which may be a chemotherapy drug (such as, without limitation, mitomycin) or an immunotherapy agent (such as without limitation, Bacillus Calmette-Guearin (BCG) bacterium) directly into the bladder. Alter delivery of the agent, the catheter is removed and the patient is instructed to not urinate for one or two or even several hours to give the agent time to act (the patient may be sent home during this period). After sufficient time to allow the agent to act has passed, the agent is voided out by the patient.
Intravesical therapy as just described is more than 20 years old. It is evident that this mode of delivery is quite crude and raises multiple concerns including, without limitation, whether the agent is being delivered to the entire bladder, and whether the agent is being delivered under less than optimal conditions such that the chance of treatment success is decreased.
In one embodiment, a catheter for delivering as hyperthermic liquid to the interior of an organ of a patient is provided that includes an inflow lumen structured to be inserted into the organ and deliver the hyperthermic liquid to the interior of the organ, and an outflow lumen structured to be inserted into the organ and evacuate the hyperthermic liquid from the interior of the organ. The catheter includes a proximal portion that is structured to be received within the internal tissue structure of the patient, wherein at least a portion of the inflow lumen and the outflow lumen are insulated in a manner wherein a temperature on art outside surface of the proximal portion of the catheter will not be more than one degree Fahrenheit above normal body temperature when the hyperthermic liquid is passed through the catheter.
In another embodiment, a method of delivering a hyperthermic treatment agent to an organ of a patient is provided. The method includes inserting a catheter into the organ of the patient through and internal tissue structure of the patient, flowing a hyperthermic liquid into and out of the organ through the catheter to raise a temperature within the organ, measuring the temperature within the organ and determining that the temperature within the organ has reached at least a predetermined level, and after determining that the temperature within the organ has reached at least the predetermined level, flowing the hyperthermic treatment agent into the organ through the catheter.
As used herein, the singular form of “a”, “an”, and “the” include plural references unless the context clearly dictates otherwise.
As used herein, the statement that two or more parts or elements are “coupled” shall mean that the parts are joined or operate together either directly or indirectly, i.e., through one or more intermediate parts or elements, so long as a link occurs.
As used herein, “directly coupled” means that two elements are directly in contact with each other.
As used herein, “fixedly coupled” or “fixed” means that two elements are coupled so as to move as one while maintaining a constant orientation relative to each other.
As used herein, the word “unitary” means a part is created as a single piece or unit. That is, a part that includes pieces that are created separately and then coupled together as a unit is not a “unitary” part or body.
As employed herein, the statement that two or more parts or elements “engage” one another shall mean that the parts exert a force against one another either directly or through one or more intermediate parts or elements.
As employed herein, the term “number” shall mean one or an integer greater than one (i.e., a plurality).
As used herein, the term “component” is intended to refer to a computer related entity, either hardware, a combination of hardware and software, software, or software in execution. For example, a component can be, but is not limited to being, a process running on a processor, a processor, an object, an executable, a thread of execution, a program, and/or a computer. By way of illustration, both an application running on a server and the server can be a component. One or more components can reside within a process and/or thread of execution, and a component can be localized on one computer and/or distributed between two or more computers.
As used herein, the term “normal body temperature” shall mean 98.6° Fahrenheit.
As used herein, the term “hyperthermic” shall mean above normal body temperature.
Directional phrases used herein, such as, for example and without limitation, top, bottom, left, right, upper, lower, front, back, and derivatives thereof, relate to the orientation of the elements shown in the drawings and are not limiting upon the claims unless expressly recited therein.
As seen in
First end 14 of inflow lumen 6 includes a male Luer fitting 28 and a pressure sensor 30. Male Luer fitting 28 is structured to enable a syringe, such as heated syringe 32 (i.e. a syringe holding a heated liquid), to be coupled thereto for injecting a fluid, such as heated saline, a hyperthermic chemotherapeutic agent or a hyperthermic immunotherapeutic agent, into inflow lumen 6. Pressure sensor 30 is provided in line with inflow lumen 6 and is structured to measure the pressure of the fluid passing through inflow lumen 6 and thus the pressure within the patient's bladder). First end 18 of outflow lumen 8 includes a female Luer fitting 34 and an outflow shut off valve 36. Female Luer fitting 34 is structured to enable a drain bag 38 to be coupled thereto for receiving, fluids that are evacuated through outflow lumen 8 as described herein. First end 22 of balloon lumen 10 includes a female Toomey fitting 48 that is structured to enable a syringe 50 to be coupled to balloon lumen 10 for injecting air into and withdrawing air from balloon lumen 10 in order to selectively inflate and deflate sealing balloon 12.
As seen in
In an alternative embodiment, rather than providing insulating material 51 at portion 49, inflow lumen 6 and outflow lumen 8 may be manufactured from insulative materials that provide the insulator function just described. In such a configuration, the materials are chosen such that the external surfaces of inflow lumen 6 and outflow lumen 10 will be no more than one degree Fahrenheit above normal body temperature. As a result, the exterior surface of portion 49 will not experience an undesirable temperature increase.
In one exemplary embodiment, inflow lumen 6 and outflow lumen 10 are both made of polytetrafluoroethylene (PTFE), with each having an inside diameter of approximately 0.0625 inches and a wall thickness of approximately 0.020 inches. In addition, in this exemplary embodiment, insulating material 51 is a silicone elastomer and the outer diameter of portion 49 of catheter 4 is 16 French.
Catheter 4 further includes a temperature sensor 52 coupled to and provided at end 16 of inflow lumen 6. In the illustrated embodiment, temperature sensor 52 is directly coupled to the exterior of the and 16 of inflow lumen 6. In the exemplary embodiment, temperature sensor 52 is a thermistor, and more specifically a bead thermistor. Also in the exemplary embodiment temperature sensor 52 is positioned such that approximately half of the body thereof extends past the terminal end of catheter 4 at end 16 of inflow lumen 6. Temperature sensor 52 is structured to measure the temperature in the patient's bladder when catheter 4 is inserted therein. Temperature sensor 52. is coupled to a patient monitor component 54 (described below) forming a part of infusion system 2 b a wire 56 that extends down along a portion of the length of inflow lumen 6. Also coupled to patient monitor component 54 is pressure sensor 30 by way of a wire 58.
Patient monitor component 54 is a computing device that is structured to receive the measurements/readings from pressure sensor 30 and temperature sensor 52 and display such readings visually so that they may be monitored by a physician or other health-care provider.
Finally, referring again to
In one particular, non-limiting embodiment, pressure measurements are made during steps 102 and 106 of
Thus, the system and method of drug delivery described herein in the various embodiments offers a number of advantages important to the implementation of more effective local therapies of bladder cancer. First, they allow the sequential administration of different elements of intravesical therapies within one overall procedure individually or in defined combination (for example, chemotherapeutic agents, small molecule inhibitors and modulators of inflammation, and biological agents). Second, they also facilitate the uniform and consistent exposure of tumor tissues to the selected concentrations of biologic and chemotherapeutic agents. Third, they allow the controlled and consistent use of local bladder hyperthermia to: a) enhance the tumor uptake of chemotherapeutic or biologic factors; b) modify the pattern of the resulting inflammatory response within the tumor tissues; and c) promote tumor entry of immune cells. Fourth, they allow for longitudinal monitoring of a) uptake of the applied therapeutic agents and b) the response to such agents, measured by the rates of local release of pro- and anti-inflammatory factors, allowing for personalized patient-specific adjustment of the composition and/or concentrations of the therapeutic factors, in order to assure their optimal effectiveness and to minimize the side-effects.
Furthermore, the treatment methods described herein can be conducted as an outpatient procedure, with minimal to no patient morbidity. The treatments are also minimally invasive, requiring simply the insertion of the catheter 4 before and then subsequent removal of the catheter 4 after the treatments. In addition, the treatment methods may potentially reduce treatment discomfort by allowing patients to rest comfortably during treatment periods rather than being asked to “hold in” a chemotherapeutic and/or immunotherapeutic agent. In this regard, it is believed that the treatment methods described herein will play an important role in enhancing the efficacy and tolerability of bladder cancer treatment for years to come.
Moreover, while the invention has been described herein in the various embodiments in connection with treatments for bladder cancer, it will be understood that the infusion system 2, catheter 4 and methods described herein may also be used to treat cancers of other body organs such as, without limitation, the kidneys.
In the claims, any reference signs placed between parentheses shall not be construed as limiting the claim The word “comprising” or “including” does not exclude the presence of elements or steps other than those listed in a claim. In a device claim enumerating several means, several of these means may he embodied by one and the same item of hardware. The word “a” or “an” preceding an element does not exclude the presence of a plurality of such elements. In any device claim enumerating several means, several of these means may be embodied by one and the same item of hardware. The mere fact that certain elements are recited in mutually different dependent claims does not indicate that these elements cannot be used in combination.
Although the invention has been described in detail for the purpose of illustration based on what is currently considered to be the most practical and preferred embodiments, it is to be understood that such detail is solely for that purpose and that the invention is not limited to the disclosed embodiments, but, on the contrary, is intended to cover modifications and equivalent arrangements that are within the spirit and scope of the appended claims. For example, it is to be understood that the present invention contemplates that, to the extent possible, one or more features of any embodiment can be combined with one or more features of any other embodiment.
This application claims priority under 35 U.S.C. §119(e) from U.S. provisional patent application No. 62/034,918, entitled “System and Method for Delivering Cancer Treating Agents to an Organ such as the Bladder” and filed on Aug. 8, 2014, the contents of which are incorporated herein by reference.
Number | Date | Country | |
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62034918 | Aug 2014 | US |