Local regional recurrence (LRR) remains the primary cause of treatment failure in solid tumors despite advancements in cancer therapies. Canady Helios Cold Plasma (CHCP) is a novel Cold Atmospheric Plasma device that generates an Electromagnetic Field and Reactive Oxygen and Nitrogen Species to induce cancer cell death. In the first FDA-approved Phase I trial (March 2020–April 2021), 20 patients with stage IV or recurrent solid tumors underwent surgical resection combined with intra-operative CHCP treatment. Safety was the primary endpoint; secondary endpoints were non-LRR, survival, cancer cell death, and the preservation of surrounding healthy tissue. CHCP did not impact intraoperative physiological data (p > 0.05) or cause any related adverse events. Overall response rates at 26 months for R0 and R0 with microscopic positive margin (R0-MPM) patients were 69% (95% CI, 19–40%) and 100% (95% CI, 100–100.0%), respectively. Survival rates for R0 (n = 7), R0-MPM (n = 5), R1 (n = 6), and R2 (n = 2) patients at 28 months were 86%, 40%, 67%, and 0%, respectively. The cumulative overall survival rate was 24% at 31 months (n = 20, 95% CI, 5.3–100.0). CHCP treatment combined with surgery is safe, selective towards cancer, and demonstrates exceptional LRR control in R0 and R0-MPM patients. (Clinical Trials identifier: NCT04267575).

A novel calcium sulfate–calcium phosphate composite injectable bone graft substitute has been approved by the FDA for filling bone defects in a nonweightbearing application based on preclinical studies. Its utility has not been documented in the literature. We therefore determined postoperative function and complications in patients with benign bone lesions treated with this bioceramic. We retrospectively reviewed all 56 patients with benign bone lesions treated with the bioceramic from 2006 to 2008. There were 29 male and 27 female patients with an average age of 17.6 years (range, 4–63 years). They were treated for the following diagnoses: unicameral bone cyst (13), aneurysmal bone cyst (10), nonossifying fibroma (eight), fibrous dysplasia (five), enchondroma (four), chondroblastoma (four), and other (12). We obtained a Musculoskeletal Tumor Society (MSTS) functional evaluation on all patients. The minimum followup was 26 months (average, 42 months; range, 26–57 months). The average MSTS score was 29 (range, 20–30). Most patients returned to normal function. There were three local recurrences, all of which were treated with repeat injection or curettage. Two patients had postoperative fractures treated in a closed manner. Two patients had wound complications, neither of which required removal of the graft material. Patients treated with this material reported high MSTS functional scores more than 24 months after operative intervention and experienced low complication rates. We believe the novel bioceramic to be a reasonable treatment option for benign bone lesions. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Background: The clinical significance of subcentimeter nodules identified on staging chest computed tomography (CT) for sarcoma remains unknown. Our goal was to evaluate the effect of initial pulmonary nodule size and number on survival rates in young, newly diagnosed sarcoma patients. Methods: Medical records were reviewed for all patients ≤50 years of age with primary, high-grade bone or soft tissue sarcoma at our institution over a 10-year period. This population was divided into patients with no nodules (group 1); 1 nodule 1 nodule <5 mm (group 3); and ≥1 nodule ≥5 mm (group 4). Kaplan-Meier analyses with log rank tests were performed to compare overall and disease-free survival between these 4 groups, as well as between patients with unilateral and bilateral nodules. Results: There were 74 patients in group 1 (59.2%), 26 in group 2 (21%), 11 in group 3 (9%), and 13 in group 4 (10%). Mean follow-up was 74 (range, 6 to 191 mo) months. Survival was only slightly worse with larger nodules but significantly worse with multiple nodules. In addition, patients with bilateral nodules had a significantly worse prognosis than those with multiple unilateral nodules. Conclusions: These data suggest that in young patients with high-grade sarcoma, the number and distribution of subcentimeter pulmonary nodules are an important prognostic factor, whereas nodule size may be less relevant.

Soft tissue sarcomas (STS) are a rare and highly heterogeneous group of solid tumors, originating from various types of connective tissue. Complete removal of STS by surgery is challenging due to the anatomical location of the tumor, which results in tumor recurrence. Additionally, current polychemotherapeutic regimens are highly toxic with no rational survival benefit. Cold atmospheric plasma (CAP) is a novel technology that has demonstrated immense cancer therapeutic potential. Canady Cold Helios Plasma (CHCP) is a device that sprays CAP along the surgical margins to eradicate residual cancer cells after tumor resection. This preliminary study was conducted in vitro prior to in vivo testing in a humanitarian compassionate use case study and an FDA-approved phase 1 clinical trial (IDE G190165). In this study, the authors evaluate the efficacy of CHCP across multiple STS cell lines. CHCP treatment reduced the viability of four different STS cell lines (i.e., fibrosarcoma, synovial sarcoma, rhabdomyosarcoma, and liposarcoma) in a dose-dependent manner by inhibiting proliferation, disrupting cell cycle, and inducing apoptosis-like cell death.