Antitumor effectiveness of electrochemotherapy: A systematic review and meta-analysis

Mali, Barbara Černič; Jarm, Tomaž; Snoj, Marko; Serša, Gregor; Miklavčič, Damijan

doi:10.1016/j.ejso.2012.08.016

Cited by 324 publications

(251 citation statements)

References 80 publications

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“…Although reversible electroporation has many applications in the medical field, gene transfer,29 and electrochemotherapy,30, 31 it is IRE that garnishes much attention and interest and has been harnessed as a clinical tool in the management of noncardiac pathological conditions 13, 32, 33, 34, 35. The findings of this investigation recapitulate the ability of electroporation to produce both reversible and irreversible effects on tissue.…”

Section: Discussionmentioning

confidence: 55%

Elimination of Purkinje Fibers by Electroporation Reduces Ventricular Fibrillation Vulnerability

Livia

Sugrue

Witt

et al. 2018

JAHA

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BackgroundThe Purkinje network appears to play a pivotal role in the triggering as well as maintenance of ventricular fibrillation. Irreversible electroporation (IRE) using direct current has shown promise as a nonthermal ablation modality in the heart, but its ability to target and ablate the Purkinje tissue is undefined. Our aim was to investigate the potential for selective ablation of Purkinje/fascicular fibers using IRE.Methods and ResultsIn an ex vivo Langendorff model of canine heart (n=8), direct current was delivered in a unipolar manner at various dosages from 750 to 2500 V, in 10 pulses with a 90‐μs duration at a frequency of 1 Hz. The window of ventricular fibrillation vulnerability was assessed before and after delivery of electroporation energy using a shock on T‐wave method. IRE consistently eradicated all Purkinje potentials at voltages between 750 and 2500 V (minimum field strength of 250–833 V/cm). The ventricular electrogram amplitude was only minimally reduced by ablation: 0.6±2.3 mV (P=0.03). In 4 hearts after IRE delivery, ventricular fibrillation could not be reinduced. At baseline, the lower limit of vulnerability to ventricular fibrillation was 1.8±0.4 J, and the upper limit of vulnerability was 19.5±3.0 J. The window of vulnerability was 17.8±2.9 J. Delivery of electroporation energy significantly reduced the window of vulnerability to 5.7±2.9 J (P=0.0003), with a postablation lower limit of vulnerability=7.3±2.63 J, and the upper limit of vulnerability=18.8±5.2 J.ConclusionsOur study highlights that Purkinje tissue can be ablated with IRE without any evidence of underlying myocardial damage.

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Section: Discussionmentioning

confidence: 55%

Elimination of Purkinje Fibers by Electroporation Reduces Ventricular Fibrillation Vulnerability

Livia

Sugrue

Witt

et al. 2018

JAHA

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“…ECT, which is currently the most developed electroporation-based therapy (Mali et al 2013;, improves chemotherapy outcome by increasing the plasma membrane permeability to cytotoxic drugs with exposure of target cells (i.e., tumor) to a high-strength electric field . The electric field is caused by high-voltage electric pulses that are delivered to the target tissue (i.e., tumor) using electrodes (Mir et al 1991).…”

Section: Introductionmentioning

confidence: 99%

Planning of Electroporation-Based Treatments Using Web-Based Treatment-Planning Software

et al. 2013

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Electroporation-based treatment combining high-voltage electric pulses and poorly permanent cytotoxic drugs, i.e., electrochemotherapy (ECT), is currently used for treating superficial tumor nodules by following standard operating procedures. Besides ECT, another electroporation-based treatment, nonthermal irreversible electroporation (N-TIRE), is also efficient at ablating deepseated tumors. To perform ECT or N-TIRE of deep-seated tumors, following standard operating procedures is not sufficient and patient-specific treatment planning is required for successful treatment. Treatment planning is required because of the use of individual long-needle electrodes and the diverse shape, size and location of deepseated tumors. Many institutions that already perform ECT of superficial metastases could benefit from treatmentplanning software that would enable the preparation of patient-specific treatment plans. To this end, we have developed a Web-based treatment-planning software for planning electroporation-based treatments that does not require prior engineering knowledge from the user (e.g., the clinician). The software includes algorithms for automatic tissue segmentation and, after segmentation, generation of a 3D model of the tissue. The procedure allows the user to define how the electrodes will be inserted. Finally, electric field distribution is computed, the position of electrodes and the voltage to be applied are optimized using the 3D model and a downloadable treatment plan is made available to the user.

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“…Since its discovery and the first investigations in the 1960s and 1970s (4,5), electroporation has been used in a wide range of applications, including gene transfection (6), wound and water sterilization (7,8), tumor ablation (9,10), electrochemotherapy (11,12), and transdermal drug delivery (13). Furthermore, links to defibrillation damage have been highlighted (14).…”

mentioning

confidence: 99%

Imaging the dynamics of individual electropores

Sengel

Wallace

2016

Proc. Natl. Acad. Sci. U.S.A.

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Electroporation is a widely used technique to permeabilize cell membranes. Despite its prevalence, our understanding of the mechanism of voltage-mediated pore formation is incomplete; methods capable of visualizing the time-dependent behavior of individual electropores would help improve our understanding of this process. Here, using optical single-channel recording, we track multiple isolated electropores in real time in planar droplet interface bilayers. We observe individual, mobile defects that fluctuate in size, exhibiting a range of dynamic behaviors. We observe fast (25 s −1 ) and slow (2 s −1 ) components in the gating of small electropores, with no apparent dependence on the applied potential. Furthermore, we find that electropores form preferentially in the liquid disordered phase. Our observations are in general supportive of the hydrophilic toroidal pore model of electroporation, but also reveal additional complexity in the interactions, dynamics, and energetics of electropores.droplet interface bilayer | electroporation | toroidal pores | optical single-channel recording | lipid bilayers

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Antitumor effectiveness of electrochemotherapy: A systematic review and meta-analysis

Cited by 324 publications

References 80 publications

Elimination of Purkinje Fibers by Electroporation Reduces Ventricular Fibrillation Vulnerability

Elimination of Purkinje Fibers by Electroporation Reduces Ventricular Fibrillation Vulnerability

Planning of Electroporation-Based Treatments Using Web-Based Treatment-Planning Software

Imaging the dynamics of individual electropores

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