Selected Research Highlights from ILF-CLF Niagara Falls 2025

Written by: Lyn Anglin

The International Lymphoedema Foundation/Canadian Lymphedema Foundation Conference (ILF/CLF) in Niagara Falls included a number of keynote talks and extended abstract sessions on various aspects of lymphedema research.  

A lot of exciting and encouraging research results were presented. I have highlighted a few here that really resonated with me because they indicate that those of us with lymphedema should not lose hope that new treatments may some day be available. In addition, a number of presentations on early diagnosis protocols also give me hope that new Standards of Care, especially for cancer patients at high risk of developing lymphedema from cancer treatment, are available to help catch lymphedema at very early stages, which can lead to early intervention which can reduce and sometimes possibly even prevent, the development of lymphedema. Now, we just need to get those Standars of Care adopted and supported in our health care system!

The first keynote lecture on opening day was presented by Dr. Wei F. Chen, titled “Supermicrosurgical Treatment of Alzheimer’s Disease, aka Brain Lymphedema – Is it a Clinical Reality?” Dr Chen presented on observations of some Alzheimer’s as a sort of primary “lymphedema of the brain” and the possible cause-effect between brain lymphatics and Alzheimer’s replicated in animals. He showed a video of the very positive impacts of lymphatic supermicrosurgery done by a Chinese colleague on an 84-year old male bedridden Alzheimer’s patient in China. He also referred us to his talk at AARS 2023 “Rewiring the Brain – Next 100 years in Plastic Surgery”. He noted that their research findings are preliminary and they are continuing their study, but he was quite optimistic about the potential for lymphatic reconstruction for treating some brain disorders. Here is a link to a related 2024 publication: Rewiring the Brain: The Next Frontier in Supermicrosurgery - PubMed which includes the video he showed in his talk.

On the second day of the conference, Dr. Stanley Rockson gave the first keynote talk of the day, titled “The Search for a Drug for Human Lymphedema”. He gave a great update on his “ongoing quest to develop a pharmacological treatment for human lymphedema”. He noted that some of his past research trials had to be redirected, but he also presented some very positive results of his recent studies. The results indicate the potential to reverse some of the effects of lymphedema in mice, and in preliminary trials on human subjects he is seeing significant reduction in limb volume over time. 

Another very interesting presentation on potential drug treatment was given by graduate student Frederik Gulmark Hansen from Odense University Hospital in Denmark. Titled “Advancing Pharmacological Treatment for Breast Cancer-Related Lymphedema: An overview and perspectives from Clinical Studies on Topical Tacrolimus”, this talk presented the results of two clinical studies that are investigating the potential therapeutic role of a drug called Tacrolimus in treating breast cancer-related lymphedema (BCRL). Early-phase clinical trials indicated that topical Tacrolimus (a drug that is presently used in treating skin conditions like eczema) “reduces inflammation, enhances lymphatic function, and mitigates fibrosis but also exerts a preventative effect on lymphedema development”, “though long-term efficacy remains to be established”. They are continuing their research with an ongoing randomized controlled trial which aims to confirm their study results to-date. I am going to stay tuned for publications of their results! 

On the third day of the conference, one of the session I attended was titled "From Assessment to Action – Innovation in BCRL Diagnosis and Management”. This was a great session, with several excellent presentations on early diagnosis and measurement techniques for lymphedema. 

Cheryl Brunelle, Massachusetts General Hospital gave a presentation titled “Agreement of Breast Cancer-Related Lymphedema Diagnosis Across Commonly Utilized Diagnostic Criteria: A Cross-Sectional Observational Cohort Study.” She noted that the “lack of standardized diagnostic criteria for … BCRL has been a longstanding impediment to research studies and clinical practice. Her research looked at analyzing BCRL diagnostics and undertook to “determine which diagnostic threshold diagnoses BCRL most frequently” and compare the time required to complete measurements using different diagnostic techniques. Measurement options investigated included BIS (bioimpedance spectroscopy), TDC (tissue dielectric constant), girth measures (tape, converted to volume), 3D camera, and perometer (noting that the last 3 measure relative volume change). TDC measures percent of water content under the skin, BIS measures extracellular fluid. She noted that both arms should be measured every time, and pre-operative measurement is critical. In their study tape measures were always converted to volume, and they used the SOZO BIS system. She noted that results depended on the diagnostic tool used. No one tool is a silver bullet. “Development of universal BCRL diagnostic criteria is imperative.” The research paper was published in Rehabilitation Oncology (2025).

Louise Kohlmeyer from the ALERT Centre at Macquarie Univ in Australia spoke about the RE-AIM Framework, “Implementing prospective surveillance and early intervention into clinical practice using the RE-AIM framework”. The RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) Framework study is a retrospective analysis of results from the PREVENT Trial which looked at efficacy of surveillance, early diagnosis and early intervention. The RE-AIM results indicated that 25% of 219 patients (n= 55) triggered an early intervention, and then only 1.8% of those (n = 4) progressed to clinical lymphedema over 2 years of the study. She noted that free compression garments were available to study participants whose surveillance results triggered an early diagnosis of lymphedema. She concluded that to make this system work you need buy-in from the whole medical and health care team involved in BCRL care. She noted the challenges of implementing science, i.e. translating scientific evidence into routine clinical practice, and that it can take up to 17 years for published science to make it into clinical practice. The introduction in her abstract states “Despite international guidelines and evidence-based research advocating for prospective surveillance and early intervention model of care (PSM), its integrating into clinical practice remains challenging.” 

In response to my question about how to get early diagnosis and screening programs like this set up, Louise responded that “slow and steady” work is needed. Keep talking about it. Persevere! It took them 10 years to get the Standard of Care accepted in many surgeries, hospitals and cancer centres in Australia. She noted that it is very slow in the lymphedema world to get research results into clinics. The pace of adoption is especially slow compared to oncology research and cancer treatments. 

All in all, the conference was excellent, with lots of very informative presentations. If you are interested in more information on any of these talks, I have downloaded the abstracts and may be able to provide additional detail on the talks that I have summarized above as well as some of the others that I attended.

Lyn Anglin