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Advances in Minimally Invasive Lung Cancer Therapies

Publication Title: Advances in Percutaneous and Endovascular Locoregional Therapies for Primary and Metastatic Lung Cancer

Summary

Question
This review explored advancements in minimally invasive locoregional therapies for lung cancer, specifically image-guided thermal ablation (IGTA) and bronchial artery chemoembolization (BACE). The study focused on technological improvements, clinical outcomes, and the potential for combining these treatments with systemic therapies such as immunotherapy, chemotherapy, and radiation.
Why it Matters
Lung cancer is the leading cause of cancer-related deaths worldwide, with many patients unable to undergo surgery, radiation, or systemic therapy due to age, advanced disease, or other health conditions. These limitations highlight the need for alternative treatments. IGTA and BACE offer minimally invasive options that can target tumors while sparing healthy lung tissue. Recent innovations have improved their precision and safety, expanding their potential to improve survival, symptom relief, and quality of life, especially for patients with limited treatment options.
Methods
The authors reviewed recent studies, clinical trials, and emerging technologies related to IGTA and BACE. They focused on developments in energy delivery, imaging guidance, and treatment protocols, as well as the integration of these therapies with other treatments. Data were synthesized from studies published between 2020 and 2026, using targeted searches of medical literature and clinical guidelines.
Key Findings
Advancements in IGTA include improved energy delivery methods, such as microwave ablation (MWA) and cryoablation, which allow for precise tumor targeting and preservation of healthy tissue. Enhanced imaging technologies, like cone beam CT and electromagnetic navigation, have expanded the range of treatable tumors. BACE, which delivers chemotherapy directly to tumors via blood vessels, has shown promise in controlling advanced disease and improving symptoms. Early data suggest that combining IGTA or BACE with immunotherapy or chemotherapy may enhance treatment effectiveness without increasing toxicity.
Implications
These findings suggest that IGTA and BACE could play an increasing role in lung cancer care, particularly for patients who are not candidates for surgery or other standard treatments. By integrating these therapies with systemic treatments, clinicians may achieve better disease control and potentially extend survival while minimizing side effects. These approaches also address the growing need for repeatable, lung-sparing treatments in advanced and recurrent lung cancer.
Next Steps
Future research should focus on large, randomized trials to refine patient selection criteria, optimize treatment protocols, and assess long-term outcomes. Studies are also needed to establish standardized guidelines for combining IGTA and BACE with systemic therapies, as well as to explore their use in broader clinical settings.
Funding Information
This research received no external funding. Yale University also provided funding and support for this research.

Full Citation

Mihailescu M, Fish A, Madoff D. Advances in Percutaneous and Endovascular Locoregional Therapies for Primary and Metastatic Lung Cancer. Cancers 2026, 18: 1189. DOI: 10.3390/cancers18081189.

Authors

  • Maria Mihailescu

    First Author
    School Building Streamline Icon: https://streamlinehq.comOther Institution

  • David C. Madoff, MD

    Last Author
    Yale School of Medicine

    Professor of Radiology & Biomedical Imaging and Medical and Surgical Oncology

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Other Authors

  • Adam G. Fish

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