Modulated Electro-Hyperthermia as Palliative Treatment for Pancreatic Cancer: A Retrospective Observational Study on 106 Patients

Abstract

Background: Pancreatic adenocarcinoma has a poor prognosis, resulting in a <10% survival rate at 5 years. Modulated electro-hyperthermia (mEHT) has been increasingly used for pancreatic cancer palliative care and therapy. Objective: To monitor the efficacy and safety of mEHT for the treatment of advanced pancreatic cancer. Methods: We collected data retrospectively on 106 patients affected by stage III-IV pancreatic adenocarcinoma. They were divided into 2 groups: patients who did not receive mEHT (no-mEHT) and patients who were treated with mEHT. We performed mEHT applying a power of 60 to 150 W for 40 to 90 minutes. The mEHT treatment was associated with chemotherapy and/or radiotherapy for 33 (84.6%) patients, whereas 6 (15.4%) patients received mEHT alone. The patients of the no-mEHT group received chemotherapy and/or radiotherapy in 55.2% of cases. Results: Median age of the sample was 65.3 years (range = 31-80 years). After 3 months of therapy, the mEHT group had partial response in 22/34 patients (64.7%), stable disease in 10/34 patients (29.4%), and progressive disease in 2/34 patients (8.3%). The no-mEHT group had partial response in 3/36 patients (8.3%), stable disease in 10/36 patients (27.8%), and progressive disease in 23/36 patients (34.3%). The median overall survival of the mEHT group was 18.0 months (range = 1.5-68.0 months) and 10.9 months (range = 0.4-55.4 months) for the non-mEHT group. Conclusions: mEHT may improve tumor response and survival of pancreatic cancer patients.

Modulated Electro-Hyperthermia-Induced Tumor Damage Mechanisms Revealed in Cancer Models

“…Besides many positive case studies being published in a wide range of tumors, several clinical papers analyzing the statistically relevant number of patients have come out recently confirming the added benefits of mEHT treatment to conventional oncotherapy. Combination therapies involving mEHT improved tumor response and survival to radio-chemotherapy in stage III-IV pancreatic cancer patients [ 96 ], the 5-year overall survival of astrocytoma from 24% to 83% compared to the best supportive care alone [ 97 ], the dose-dense temozolomide treatment of recurrent glioblastoma in a cost-effective way [ 98 ], or the local disease-free survival and local disease control in FIGO (International Federation of Gynecology and Obstetrics) stages IIB to IIIB squamous cell carcinoma of the cervix [ 99 ]. This latter phase III randomized controlled trial in advanced cervical cancer showed a high level of clinical evidence on the support of an abscopal effect by mEHT in combination with radio-chemotherapy [ 95 ].…”

Modulated Electro-Hyperthermia Resolves Radioresistance of Panc1 Pancreas Adenocarcinoma and Promotes DNA Damage and Apoptosis In Vitro

“…In PDAC, an increasing number of clinical studies have demonstrated that different forms of high-fever range hyperthermia including WBH (whole body hyperthermia), HIPEC (hyperthermic intraperitoneal chemotherapy) and locoregional delivery may improve the effects of chemotherapy both concerning survival and quality of life parameters [ 28 , 29 , 30 ]. Recent evidences have also shown the clinical benefits of mEHT (Oncothermia) in PDAC treatment in combination with chemotherapy [ 31 , 32 , 33 ]. These data led to the initiation of clinical trials combining PDAC chemotherapy with locoregional hyperthermia generated by instruments using different radiofrequency and power ranges based either on radiative (70–120 MHz, 800–1500 W, 60 min/treatment) [ 34 ] or capacitive (mEHT: 13.56 MHz, 60–150 W, 60 min/treatment) [ 35 ] delivery.…”

Relationship between Energy Dosage and Apoptotic Cell Death by Modulated Electro-Hyperthermia

“…However, the effects of mEHT, which has a milder heating effect, as a sensitizer are being demonstrated in studies such as that by Minnaar et al 30 . Modulated electro-hyperthermia has also shown to improve disease management in palliative treatment for brain and pancreatic tumours as a standalone treatment 31,32 . The clinical results showing mEHT has an effect in the absence of higher temperatures prompted the research group to investigate other effects of the technique.…”

“…The clinical results of mEHT do not match the results observed in vitro. The limited of clinical level 1 evidence should also be noted, however, this is an area which is growing 31,32,35 . Recently, mEHT was investigated in a Phase III randomized controlled trial, as a sensitizer for CCRT for the treatment of local advance cervical cancer (LACC) patients 30 .…”