Adipose‐derived Regenerative Cells – A Safe and Effective Treatment for Breast Cancer‐related Lymphedema?

Review of “Adipose‐derived regenerative cells and lipotransfer in alleviating breast cancer‐related lymphedema: An open‐label phase I trial with 4 years of follow‐up” from STEM CELLS Translational Medicine by Stuart P. Atkinson

Previous studies from researchers associated with the laboratory of Mads Gustaf Jørgensen (University of Southern Denmark, Odense, Denmark) explored the potential of cell therapy [1] for the treatment of breast cancer‐related lymphedema, a frequent side-effect of conventional cancer treatment strategies [2]. Their previous research reported on the one-year results obtained following the transplantation of easy to isolate adipose‐derived regenerative cells, also called the stromal vascular fraction of adipose tissue [3], as an autologous treatment for breast cancer‐related lymphedema [4, 5]. In their new STEM CELLS Translational Medicine article [6], the team now reports their final study results with four years of follow‐up regarding long‐term efficiency and safety [7]. 

The authors screened thirty-four and treated ten breast cancer patients suffering from lymphedema with adipose‐derived regenerative cells and a scar‐releasing lipotransfer and followed their recovery for up to four years; interestingly, while the results of this long‐term, open‐label, phase I study failed to indicate a reduction in lymphedema volume in any patient, an analysis of patient self-reports revealed significant improvements to both upper extremity disability and arm heaviness and tension. These improvements prompted a reduction in the use of conservative lymphedema treatments in six patients, the substantial improvement in lymphedema in five patients (self-reported), and the willingness of four patients to submit themselves to repeat adipose‐derived regenerative cell treatments. Importantly, the study noted a lack of serious adverse effects or recurrence of locoregional breast cancer.

The results of this first phase I study provides proof for the safety and feasibility of adipose‐derived regenerative cell transplantation as a treatment for breast cancer‐related lymphedema; indeed, the authors observed effectiveness (as shown by improved symptoms and upper extremity function) soon after administration that sustained itself for up to four years. Overall, these encouraging results support subsequent randomized, controlled, and blinded studies to confirm findings and further document clinical efficacy.

For more on the therapeutic potential of adipose‐derived regenerative cells and novel treatments for breast cancer-related lymphedema, stay tuned to the Stem Cells Portal!

References

1. Toyserkani NM, Christensen ML, Sheikh SP, et al., Stem cells show promising results for lymphoedema treatment – A literature review. Journal of Plastic Surgery and Hand Surgery 2015;49:65-71.
2. Toyserkani NM, Jørgensen MG, Haugaard K, et al., Seroma indicates increased risk of lymphedema following breast cancer treatment: A retrospective cohort study. The Breast 2017;32:102-104.
3. Fraser JK, Wulur I, Alfonso Z, et al., Fat tissue: an underappreciated source of stem cells for biotechnology. Trends in Biotechnology 2006;24:150-154.
4. Toyserkani NM, Jensen CH, Andersen DC, et al., Treatment of Breast Cancer-Related Lymphedema with Adipose-Derived Regenerative Cells and Fat Grafts: A Feasibility and Safety Study. STEM CELLS Translational Medicine 2017;6:1666-1672.
5. Toyserkani NM, Jensen CH, Tabatabaeifar S, et al., Adipose-derived regenerative cells and fat grafting for treating breast cancer-related lymphedema: Lymphoscintigraphic evaluation with 1 year of follow-up. Journal of Plastic, Reconstructive & Aesthetic Surgery 2019;72:71-77.
6. Jørgensen MG, Toyserkani NM, Jensen CH, et al., Adipose-derived regenerative cells and lipotransfer in alleviating breast cancer-related lymphedema: An open-label phase I trial with 4 years of follow-up. STEM CELLS Translational Medicine 2021;10:844-854.
7. Toyserkani NM, Jørgensen MG, Tabatabaeifar S, et al., Concise Review: A Safety Assessment of Adipose-Derived Cell Therapy in Clinical Trials: A Systematic Review of Reported Adverse Events. STEM CELLS Translational Medicine 2017;6:1786-1794.