An update on the use of cryoablation and immunotherapy for breast cancer

Abstract

The use of cryoablation, a minimally-invasive image-guided technique to target and kill cancer cells, continues to gain traction within the medical field and with patients. This includes the use of cryoablation for the treatment of small breast cancers and focal sites of metastatic disease. In comparison to open surgical approaches, length of hospital stay and recovery time are decreased with the use of cryoablation. Research studies have also found that cryoablation may actually enhance tumor susceptibility to immunotherapy agents. Immunotherapy enhances a person’s own immune system to identify and attack cancer cells. It is proposed that after cryoablation there is increased expression of tumor specific antigens which the body can recognize as foreign invaders and with the combination of immunotherapy, result in an even more robust and efficient attack on the cancer cells. In this review we aim to highlight some of the recent advances in cryoablation which support the potential for cryoablation to induce these tumor-specific immune responses and thus supporting the use of combining cryoablation and immunotherapy for the treatment of breast cancer.

Potent induction of antitumor immunity by combining cryo‐thermal ablation with immune checkpoint inhibitors in hepatocellular carcinoma

“…Cryoablation protects the integrity of tumour antigens and thus induces strong anti‐tumour immunity 13,18 . Breast cancer patients who received ipilimumab (αCTLA4) and cryoablation demonstrated sustained proliferation of CD4 + and CD8 + T cells 43 . Combination of αPD1 with cryoablation led to anti‐tumour immune responses and delayed tumour growth of distant untreated tumours in a renal cell carcinoma model 18 .…”

Nanoplatforms Potentiated Ablation-Immune Synergistic Therapy through Improving Local Control and Suppressing Recurrent Metastasis

“…A freezing agent such as liquid nitrogen is pumped into the cryoprobe to freeze and kill the tumor cells by necrosis or apoptosis. Compared with RFA and MWA, cryoablation is less painful and has the benefit of a faster postoperative recovery [ 78 ]. Cryoablation is a relatively new option in oncotherapy and is most suitable for the treatment of elderly patients with tumors near the skin.…”

The forgotten art of cold therapeutic properties in cancer: A comprehensive historical guide

“…Today, cryosurgery can be monitored by modern imaging for precise and control zone ablation and is widely used in the clinics, showing beneficial responses in skin, liver, breast, renal, and prostate cancer alone or in combination with chemotherapy, immunotherapy (such as immune checkpoint inhibitors), radiotherapy, or embolization. 33 , 34 Furthermore, recent studies performed in mouse models have shown how cryoablation not only destroys neoplastic tissues but can also generate a systemic tumor-specific immune response, enhancing the ability of the immune system to recognize and attack cancer cells both locally and systemically, eradicating micro-metastases. 35 , 36 …”

“… 31 , 33 , 35 , 36 Interestingly, this immune response enhancement upon localized breast cancer cryotherapy has been associated with the abscopal effect that can trigger a systemic immune response that leads to the regression of the distant, untreated tumors. 34 , 35 In other words, the immune system is activated by the localized treatment and starts attacking cancer cells throughout the body. Moreover, freezing temperatures disrupt cells and mitochondrial metabolic functions, triggering Bax proteins and apoptotic pathways.…”