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Using gene
therapy, plastic surgeons have delivered cancer fighting proteins through
skin flaps placed on cancerous tumors on rats with a 79 percent reduction
in tumor volume, according to a study in the May issue of Plastic and
Reconstructive Surgery(R), the official medical journal of the American
Society of Plastic Surgeons (ASPS). This new delivery technique, which has
yet to be tested in humans, did not cause toxicity in the body of rats;
however, administering the same anti-tumor agent intravenously in humans
has previously been shown to cause liver damage.
"This new technique may allow us to reprogram skin flaps, using gene
therapy, to provide a blueprint for anti-tumor agents like Interleukin-12
to be produced in the tumor to kill cancer, while avoiding adverse side
effects," said Geoffrey Gurtner, MD, ASPS Member and study senior author.
"In this study we took skin flaps in animal models and delivered IL-12
directly to the tumor area with tremendous success. Since skin flaps are
used thousands of times each year in cancer patients, this may potentially
open up an entirely new area in plastic surgery and bring the specialty,
once again, to the center of medicine."
Gene therapy has been heralded as a new tool to restrain or prevent
tumor growth and recurrence in humans, but its use has been limited because
of serious side effects and the difficulty in concentrating anti-tumor
agents at the site of the cancer.
In the study, skin flaps (a mass of healthy tissue) taken from rats
were injected with the gene for IL-12 into the flaps' blood supply. The
flaps were then placed onto cancerous tumors on the rats.
The study found a 79 percent reduction in tumor volume for animals
treated with IL-12 compared to control animals. The treatment allowed
individual cells within the flap to become encoded with IL-12 and function
as "miniature factories" producing the IL-12 protein at very high levels in
the tumor site, according to the study.
Additionally, the serious side effects previously documented with
systemic use of IL-12 were not found in the treated rats. The liver, lung
and spleen remained normal throughout the study. The delivery technique
through free flaps did not cause liver toxicity, whereas using IL-12
intravenously in humans has been shown to cause liver damage.
"This could be a major advance for the delivery of a therapeutic agent
to diseased parts of the body," said Dr. Gurtner. "I can see this therapy
being used for breast cancer, head and neck cancers, central nervous system
malignancies, and somewhere down the line hemophilia, diabetes and
infections."
The study authors concluded that as oncologic reconstructive surgery is
a major component of plastic surgery, the delivery of a healing agent
precisely to the region where cancer was and where local recurrences are
most likely to occur, could add a new dimension to the reconstructive
function of free flaps in oncologic and reconstructive plastic surgery.
Nearly 5.2 million reconstructive plastic surgery procedures were
performed in 2007, according to ASPS statistics. More than 3.8 million
tumor removals and 57,000 breast reconstructions were performed last year.
Visit plasticsurgery for referrals to ASPS Member Surgeons and
to learn more about cosmetic and reconstructive plastic surgery.
The American Society of Plastic Surgeons is the largest organization of
board-certified plastic surgeons in the world. Representing more than 6,700
physician members, the Society is recognized as a leading authority and
information source on cosmetic and reconstructive plastic surgery. ASPS
comprises more than 90 percent of all board-certified plastic surgeons in
the United States. Founded in 1931, the Society represents physicians
certified by The American Board of Plastic Surgery or The Royal College of
Physicians and Surgeons of Canada.
American Society of Plastic Surgeons
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