Exploring new instrumentation parameters for electrochemotherapy. Attacking tumors with bursts of biphasic pulses instead of single pulses

Advances in Therapeutic Electroporation to Mitigate Muscle Contractions

“…Perhaps the first attempt to reduce muscle contractions during EBTs was made by Daskalov et al [21]. Stemming from their work in the field of electrical stimulation [25], the authors designed a bipolar pulse generator to perform reversible electroporation with chemotherapeutic agents, or electrochemotherapy (ECT).…”

“…While the authors make no comment on the severity or extent of muscle contractions, they do note that bipolar pulses were better tolerated by patients. Additionally, for the application of eight pulses as a single burst, the patients experienced only a single electrical sensation, as opposed to series of eight [21]. The technique of raising the pulse repetition rate above the frequency of tetanic contraction was later confirmed to be an effective option for unipolar pulsing as well [18,26], assuming optimal drug dosing [27].…”

“…However, as alluded to by Daskalov et al [21], altering pulse polarity can be employed to reduce the intensity of muscle contractions. According to classic literature on electrical stimulation, a bipolar pulse has a higher current threshold for action potential excitation as compared to a unipolar pulse of equivalent phase duration [28].…”

“…Electrically induced movement, while not ideal, has not prevented EBTs from being established as safe and effective treatment options for cancer [2,3,5,17,18] and other non-cancerous pathologies [19]. However, there has been a growing emphasis in the literature on developing novel techniques for performing electroporation that reduce the intensity or extent of muscle contractions [20][21][22][23][24].…”

New Modality for Electrochemotherapy of Surface Tumors

“…Their optimization is designed to find these minimal electrical conditions that lead to a significant antitumor effect. Usually, the field intensity (the amplitude), the number and the duration of different shapes of pulses have been in the focus of the investigations (4,6,7,8,11,12,18,23).…”