Addressing life-threatening conditions of the esophagus, bronchus and trachea

Esophageal, bronchial and tracheal cancers and trachea trauma have a devastating impact on patients. Unfortunately, the current treatment options, when available, carry a significant mortality and morbidity rate, and can drastically reduce the quality of life.

For the first time, Biostage is developing radically new ways to treat these life-threatening conditions. Clinical trials are being designed with the potential to demonstrate improved mortality rates, reduced complications, and enhanced patient quality of life. 

Esophageal Cancer: A Deadly Disease

Esophagectomy, the current standard of care for resectable esophageal cancer, is a complex surgical resection requiring stomach “pull-up” or the use of an intestinal segment that is resected with its arteries and veins and then repositioned in the chest to become the replacement esophagus. Esophagectomy, followed by stomach “pull-up” or intestinal interposition, carries a mortality rate at 90 days that can be as high as 19%. Post-operative complications may be life threatening. The most serious are pulmonary complications like respiratory failure and pneumonia, followed by leakage of gastrointestinal fluid in the chest from the place where the esophagus is surgically connected with the stomach or the intestine, which in turn can also lead to serious infections.

Central Lung Cancer: Isolated in the Bronchus

In lung cancer, although none of the four main cell types is exclusively central or peripheral in location, the majority of small-cell lung cancers and squamous cell carcinomas are centrally located in the bronchi. When the cancer affects the main bronchi or the tracheal bifurcation (carina), a pneumonectomy, the removal of an entire lung, may be necessary which reduces respiratory capacity by 50% and has a complication rate up to 50% and a post-surgical mortality rate of 8% to 15%. Biostage’s Cellspan bronchial implants are intended to preserve the lung enabling safe reattachment of the main airway.

Tracheal Cancer and Trauma: Limited Treatment Options

In tracheal cancer and trauma, when there is extensive damage to the trachea, currently there is no standard technique that allows to preserve tracheal length and function following resection, leading to high rates of complications and mortality. Biostage’s tracheal implants are intended to reduce complications and cost.

 

References
Alifino et al. Sleeve Pneumonectomy, Multi-Media Journal of Cardio-Thoracic Surgery, Jan. 2007 doi: 10.1510/mmcts.2006.002113.

American Cancer Society. Esophagus cancer. Atlanta, GA 2014.
Ferguson MK, Celauro AD, Prachand V. Prediction of major pulmonary complications after esophagectomy. Ann Thorac Surg. 2011;91:1494-1501.
In H, Palis BE, Merkow RP, et al. Doubling of 30-day mortality by 90 days after esophagectomy. Ann Surg. 2016;263(2):286-291.
International Agency for Research on Cancer. Oesophageal cancer: estimated incidence, mortality and prevalence worldwide in 2012. GLOBOCAN 2012 2012:http://globocan.iarc.fr/Pages/fact_sheets_cancer. Aspx?cancer=oesophagus. Accessed December 1, 2015.
Lightdale CJ. Practice guidelines: Esophageal cancer. Am J Gastroenterol. 1999;94(1):20-29.
Livstone EM. Esophageal cancer. Merck Manual Professional Version July 2014;http://www.merckmanuals.com/professional/gastrointestinal-disorders/tumo.... Accessed December 1, 2015.
Scarpa M, Valente S, Alfieri R, et al. Systematic review of health-related quality of life after esophagectomy for esophageal cancer. World J Gastroenterol. 2011;17(42):4660-4674.
van Hagen P, Hulshof MCCM, van Lanschot JJB, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366:2074-2084.