Electroporación irreversiblepresente y futuro en el tratamiento del carcinoma hepatocelular

  1. Cano , David
  2. Lasarte , Juan José
  3. Vivas , Isabel
Revista:
Anales del sistema sanitario de Navarra

ISSN: 1137-6627

Año de publicación: 2022

Volumen: 45

Número: 3

Páginas: 81-90

Tipo: Artículo

DOI: 10.23938/ASSN.1019 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Anales del sistema sanitario de Navarra

Resumen

Entre los tratamientos actuales para el carcinoma hepatocelular se encuentra un grupo de técnicas de ablación mínimamente invasivas con gran aceptación clínica por su mayor eficacia y seguridad respecto a las terapias tradicionales, bajo coste económico y aplicación ambulatoria. La electroporación irreversible es una técnica de ablación no térmica que crea nanoporos en la membrana celular mediante administración de campos eléctricos, induciendo la muerte de las células tumorales. Aunque la electroporación irreversible presenta resultados prometedores en numerosos ensayos clínicos, su control a largo plazo del crecimiento y de las recidivas tumorales es inferior al de la radiofrecuencia. La combinación de electroporación irreversible con agentes inmunológicos podría aumentar su eficacia tanto en el tratamiento de lesiones focales como de metástasis. Esta revisión realiza una actualización sobre la electroporación irreversible: procedimiento, mecanismo de acción, aplicación como tratamiento del carcinoma hepatocelular y alternativas de mejora que están aflorando en los últimos años.

Referencias bibliográficas

  • Citas MARENGO A, ROSSO C, BUGIANESI E. Liver cancer: connections with obesity, fatty liver, and cirrhosis. Annu Rev Med 2016; 67: 103-117. https://doi.org/10.1146/annurev-med-090514-013832
  • ALTEKRUSE SF, MCGLYNN KA, REICHMAN ME. Hepatocellular carcinoma incidence, mortality, and survival trends in the United States from 1975 to 2005. J Clin Oncol 2009; 27: 1485-1491. https://doi.org/10.1200/JCO.2008.20.7753
  • LLOVET JM, RICCI S, MAZZAFERRO V, HILGARD P, GANE E, BLANC JF et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 2008; 359: 378-390. https://doi.org/10.1056/nejmoa0708857
  • FORNER A, REIG M, BRUIX J. Hepatocellular carcinoma. Lancet 2018; 391: 1301–1314. https://doi.org/10.1016/S0140-6736(18)30010-2
  • Sociedad Española de Oncología Médica (SEOM). Las cifras del cáncer en España 2019. Madrid: SEOM, 2019. https://seom.org/images/SEOM_cifras_cancer_2019.pdf
  • LLOVET JM, BRÚ C, BRUIX J. Prognosis of hepatocellular carcinoma: The BCLC staging classification. Semin Liver Dis 1999; 19: 329-337. doi: 10.1055/s-2007-1007122
  • LLOVET JM, SCHWARTZ M, MAZZAFERRO V. Resection and liver transplantation for hepatocellular carcinoma. Semin Liver Dis 2005; 25: 181-200. https://doi.org/10.1055/s-2005-871198
  • SCHWARTZ M, ROAYAIE S, KONSTADOULAKIS M. Strategies for the management of hepatocellular carcinoma. Nat Clin Pract Oncol 2007; 4: 424-432. https://doi.org/10.1038/ncponc0844
  • RYAN MJ. Ablation techniques for primary and metastatic liver tumors. World J Hepatol 2016; 8: 191. https://doi.org/10.4254/wjh.v8.i3.191
  • SANGRO B. Chemoembolization and radioembolization. Best Pract Res Clin Gastroenterol 2014; 28: 909-919. https://doi.org/10.1016/j.bpg.2014.08.009
  • WAHL DR, STENMARK MH, TAO Y, POLLOM EL, CAOILI EM, LAWRENCE TS et al. Outcomes after stereotactic body radiotherapy or radiofrequency ablation for hepatocellular carcinoma. J Clin Oncol 2016; 34: 452-459. https://doi.org/10.1200/JCO.2015.61.4925
  • FINN RS, QIN S, IKEDA M, GALLE PR, DUCREUX M, KIM TY et al. Atezolizumab plus Bevacizumab in unresectable hepatocellular carcinoma. N Engl J Med 2020; 382: 1894-1905. https://doi.org/10.1056/nejmoa1915745
  • GALLE PR, FINN RS, QIN S, IKEDA M, ZHU AX, KIM TY et al. Patient-reported outcomes with atezolizumab plus bevacizumab versus sorafenib in patients with unresectable hepatocellular carcinoma (IMbrave150): an open-label, randomised, phase 3 trial. Lancet Oncol 2021; 22: 991-1001. https://doi.org/10.1016/S1470-2045(21)00151-0
  • FERRANTE ND, PILLAI A, SINGAL AG. Update on the Diagnosis and treatment of hepatocellular carcinoma. Gastroenterol Hepatol (NY). 2020; 16: 506-516. http://www.ncbi.nlm.nih.gov/pubmed/34017223
  • BHUTIANI N, PHILIPS P, SCOGGINS CR, MCMASTERS KM, POTTS MH, MARTIN RCG. Evaluation of tolerability and efficacy of irreversible electroporation (IRE) in treatment of Child-Pugh B (7/8) hepatocellular carcinoma (HCC). HPB (Oxford) 2016; 18: 593-599. https://doi.org/10.1016/j.hpb.2016.03.609
  • MOIR J, WHITE SA, FRENCH JJ, LITTLER P, MANAS DM. Systematic review of irreversible electroporation in the treatment of advanced pancreatic cancer. Eur J Surg Oncol 2014; 40: 1598-1604. https://doi.org/10.1016/j.ejso.2014.08.480
  • DAVALOS RV, MIR ILM, RUBINSKY B. Tissue ablation with irreversible electroporation. Ann Biomed Eng 2005; 33: 223-231. https://doi.org/10.1007/s10439-005-8981-8
  • WAGSTAFF PG, BUIJS M, VAN DEN BOS W, DE BRUIN DM, ZONDERVAN PJ, DE LA ROSETTE JJ et al. Irreversible electroporation: state of the art. Onco Targets Ther 2016; 9: 2437-2446. https://doi.org/10.2147/OTT.S88086
  • PAVŠELJ N, PRÉAT V, MIKLAVČIČ D. A numerical model of skin electropermeabilization based on in vivo experiments. Ann Biomed Eng 2007; 35: 2138-2144. https://doi.org/10.1007/s10439-007-9378-7
  • MILLER L, LEOR J, RUBINSKY B. Cancer cells ablation with irreversible electroporation. Technol Cancer Res Treat 2005; 4: 699-705. https://doi.org/10.1177/153303460500400615
  • KIS E, BALTÁS E, KINYÓ A, VARGA E, NAGY N, GYULAI R et al. Successful treatment of multiple basaliomas with bleomycin-based electrochemotherapy: a case series of three patients with Gorlin-Goltz syndrome. Acta Derm Venereol 2012; 92: 648-651. https://doi.org/10.2340/00015555-1361
  • THOMSON KR, KAVNOUDIAS H, NEAL RE. Introduction to irreversible electroporation - principles and techniques. Tech Vasc Interv Radiol 2015; 18: 128-134. https://doi.org/10.1053/j.tvir.2015.06.002
  • NARAYANAN G. Irreversible electroporation. Semin Intervent Radiol 2015; 32: 349-355. https://doi.org/10.1055/s-0035-1564706
  • HSIAO C-Y, HUANG KW. Irreversible electroporation: a novel ultrasound-guided modality for non-thermal tumor ablation. J Med Ultrasound 2017; 25: 195-200. https://doi.org/10.1016/j.jmu.2017.08.003
  • DOLLINGER M, BEYER LP, HAIMERL M, NIESSEN C, JUNG EM, ZEMAN F, STROSZCZYNSKI C et al. Adverse effects of irreversible electroporation of malignant liver tumors under CT fluoroscopic guidance: a single-center experience. Diagnostic Interv Radiol 2015; 21: 471-475. https://doi.org/10.5152/dir.2015.14442
  • BHATIA SS, ARYA R, NARAYANAN G. NICHE Applications of irreversible electroporation. Tech Vasc Interv Radiol 2015; 18: 170-175. https://doi.org/10.1053/j.tvir.2015.06.008
  • DEODHAR A, DICKFELD T, SINGLE GW, HAMILTON WC JR, THORNTON RH, SOFOCLEOUS CT et al. Irreversible electroporation near the heart: ventricular arrhythmias can be prevented with ECG synchronization. AJR Am J Roentgenol 2011; 196: W330-W335. https://doi.org/10.2214/AJR.10.4490
  • DISTELMAIER M, BARABASCH A, HEIL P, KRAEMER NA, ISFORT P, KEIL S et al. Midterm Safety and efficacy of irreversible electroporation of malignant liver tumors located close to major portal or hepatic veins. Radiology 2017; 285: 1023-1031. https://doi.org/10.1148/radiol.2017161561
  • SCHEFFER HJ, NIELSEN K, DE JONG MC, VAN TILBORG AA, VIEVEEN JM, BOUWMAN AR et al. Irreversible electroporation for nonthermal tumor ablation in the clinical setting: a systematic review of safety and efficacy. J Vasc Interv Radiol 2014; 25: 997-1011. https://doi.org/10.1016/j.jvir.2014.01.028
  • BRUIX J, REIG M, SHERMAN M. Evidence-based diagnosis, staging, and treatment of patients with hepatocellular carcinoma. Gastroenterology 2016; 150: 835-853. https://doi.org/10.1053/j.gastro.2015.12.041
  • VILLANUEVA A. Hepatocellular carcinoma. N Engl J Med 2019; 380: 1450-1462. https://doi.org/10.1056/NEJMra1713263
  • SPILIOTIS AE, GÄBELEIN G, HOLLÄNDER S, SCHERBER P-R, GLANEMANN M, PATEL B. Microwave ablation compared with radiofrequency ablation for the treatment of liver cancer: a systematic review and meta-analysis. Radiol Oncol 2021; 55: 247-258. https://doi.org/10.2478/raon-2021-0030
  • GALLE PR, FORNER A, LLOVET JM, MAZZAFERRO M, PISCAGLIA F, RAOUL JL et al. EASL Clinical Practice Guidelines: management of hepatocellular carcinoma. J Hepatol 2018; 69: 182-236. https://doi.org/10.1016/j.jhep.2018.03.019
  • FONSECA AZ, SAAD WA, RIBEIRO JR. MA. Complications after radiofrequency ablation of 233 hepatic tumors. Oncology 2015; 89: 332-336. https://doi.org/10.1159/000439089
  • KINGHAM TP, KARKAR AM, D'ANGELICA MI, ALLEN PJ, DEMATTEO RP, GETRAJDMAN GI et al. Ablation of perivascular hepatic malignant tumors with irreversible electroporation. J Am Coll Surg 2012; 215: 379–387. https://doi.org/10.1016/j.jamcollsurg.2012.04.029
  • PHILIPS P, HAYS D, MARTIN RCG. Irreversible electroporation ablation (IRE) of unresectable soft tissue tumors: learning curve evaluation in the first 150 patients treated. PLoS One 2013; 8: e76260. https://doi.org/10.1371/journal.pone.0076260
  • GUPTA P, MARALAKUNTE M, SAGAR S, KUMAR-M P, BHUJADE H, CHALUVASHETTY SB et al. Efficacy and safety of irreversible electroporation for malignant liver tumors: a systematic review and meta-analysis. Eur Radiol 2021; 31: 6511-6521. https://doi.org/10.1007/s00330-021-07742-y
  • CHEUNG W, KAVNOUDIAS H, ROBERTS S, SZKANDERA B, KEMP W, THOMSON KR. Irreversible electroporation for unresectable hepatocellular carcinoma: Initial experience and review of safety and outcomes. Technol Cancer Res Treat 2013; 12: 233-241. https://doi.org/10.7785/tcrt.2012.500317
  • SUTTER O, CALVO J, N'KONTCHOU G, NAULT JC, OURABIA R, NAHON P et al. Safety and efficacy of irreversible electroporation for the treatment of hepatocellular carcinoma not amenable to thermal ablation techniques: A retrospective single-center case series. Radiology 2017; 284: 877-886. https://doi.org/10.1148/radiol.2017161413
  • NIESSEN C, BEYER LP, PREGLER B, DOLLINGER M, TRABOLD B, SCHLITT HJ et al. Percutaneous ablation of hepatic tumors using irreversible electroporation: a prospective safety and midterm efficacy study in 34 patients. J Vasc Interv Radiol 2016; 27: 480-486. https://doi.org/10.1016/j.jvir.2015.12.025
  • PADIA SA, JOHNSON GE, YEUNG RS, PARK JO, HIPPE DS, KOGUT MJ. Irreversible electroporation in patients with hepatocellular carcinoma: immediate versus delayed findings at MR imaging. Radiology 2016; 278: 285-294. https://doi.org/10.1148/radiol.2015150031
  • FREEMAN E, CHEUNG W, KAVNOUDIAS H, MAJEED A, KEMP W, ROBERTS SK. Irreversible Electroporation for hepatocellular carcinoma: longer-term outcomes at a single centre. Cardiovasc Intervent Radiol 2021; 44: 247-253. https://doi.org/10.1007/s00270-020-02666-4
  • MAFELD S, WONG JJ, KIBRIYA N, STENBERG B, MANAS D, BASSETT P et al. Percutaneous irreversible electroporation (IRE) of Hepatic malignancy: a bi-institutional analysis of safety and outcomes. Cardiovasc Intervent Radiol 2019; 42: 577-583. https://doi.org/10.1007/s00270-018-2120-z
  • KALRA N, GUPTA P, GORSI U, BHUJADE H, CHALUVASHETTY SB, DUSEJA A et al. Irreversible electroporation for unresectable hepatocellular carcinoma: initial experience. Cardiovasc Intervent Radiol 2019; 42: 584-590. https://doi.org/10.1007/s00270-019-02164-2
  • FREEMAN E, CHEUNG W, FERDOUSI S, KAVNOUDIAS H, MAJEED A, KEMP W et al. Irreversible electroporation versus radiofrequency ablation for hepatocellular carcinoma: a single centre propensity-matched comparison. Scand J Gastroenterol 2021; 56: 942-947. doi: 10.1080/00365521.2021.1930145
  • GOMAA AI. Recent advances in multidisciplinary management of hepatocellular carcinoma. World J Hepatol 2015; 7: 673. https://doi.org/10.4254/wjh.v7.i4.673
  • CANNON RM, BOLUS DN, WHITE JA. Irreversible electroporation as a bridge to liver transplantation. Am Surg 2019; 85: 103-110. http://www.ncbi.nlm.nih.gov/pubmed/30760354
  • WISSNIOWSKI TT, HÄNSLER J, NEUREITER D, et al. Activation of tumor-specific T lymphocytes by radio-frequency ablation of the VX2 hepatoma in rabbits. Cancer Res 2003; 63: 6496-6500. http://www.ncbi.nlm.nih.gov/pubmed/14559842
  • WISSNIOWSKI TT, HÄNSLER J, NEUREITER D, FRIESER M, SCHABER S, ESSLINGER B et al. Enhancement of tumor-associated antigen-specific T cell responses by radiofrequency ablation of hepatocellular carcinoma. Hepatology 2013; 57: 1448-1457. https://doi.org/10.1002/hep.26153
  • ZHOU Y, XU X, DING J, JING X, WANG F, WANG Y, WANG P. Dynamic changes of T-cell subsets and their relation with tumor recurrence after microwave ablation in patients with hepatocellular carcinoma. J Cancer Res Ther 2018; 14: 40. https://doi.org/10.4103/jcrt.JCRT_775_17
  • CHU KF, DUPUY DE. Thermal ablation of tumours: biological mechanisms and advances in therapy. Nat Rev Cancer 2014; 14: 199-208. https://doi.org/10.1038/nrc3672
  • BULVIK BE, ROZENBLUM N, GOUREVICH S, AHMED M, ANDRIYANOV AV, GALUN E et al. Irreversible electroporation versus radiofrequency ablation: a comparison of local and systemic effects in a small-animal model. Radiology 2016; 280: 413-424. https://doi.org/10.1148/radiol.2015151166
  • ZHAO J, WEN X, TIAN L, LI T, XU C, WEN X et al. Irreversible electroporation reverses resistance to immune checkpoint blockade in pancreatic cancer. Nat Commun 2019; 10: 899. https://doi.org/10.1038/s41467-019-08782-1
  • HE C, SUN S, ZHANG Y, LI S. Irreversible Electroporation plus anti-PD-1 antibody versus irreversible electroporation alone for patients with locally advanced pancreatic cancer. J Inflamm Res 2021; 14: 4795-4807. https://doi.org/10.2147/JIR.S331023
  • BURBACH BJ, O'FLANAGAN SD, SHAO Q, YOUNG KM, SLAUGHTER JR, ROLLINS MR et al. Irreversible electroporation augments checkpoint immunotherapy in prostate cancer and promotes tumor antigen-specific tissue-resident memory CD8+ T cells. Nat Commun 2021; 12: 3862. https://doi.org/10.1038/s41467-021-24132-6
  • CHEN X, REN Z, YIN S, XU Y, GUO D, XIE H et al. The local liver ablation with pulsed electric field stimulate systemic immune reaction against hepatocellular carcinoma (HCC) with time-dependent cytokine profile. Cytokine 2017; 93: 44-50. https://doi.org/10.1016/j.cyto.2017.05.003
  • SUGIMOTO K, KAKIMI K, TAKEUCHI H, FUJIEDA N, SAITO K, SATO E et al. Irreversible electroporation versus radiofrequency ablation: comparison of systemic immune responses in patients with hepatocellular carcinoma. J Vasc Interv Radiol 2019; 30: 845-853.e6. https://doi.org/10.1016/j.jvir.2019.03.002
  • DAI Z, WANG Z, LEI K, LIAO J, PENG Z, LIN M et al. Irreversible electroporation induces CD8+ T cell immune response against post-ablation hepatocellular carcinoma growth. Cancer Lett 2021; 503: 1-10. https://doi.org/10.1016/j.canlet.2021.01.001
  • ALNAGGAR M, LIN M, MESMAR A, LIANG S, QAID A, XU K et al. Allogenic natural killer cell immunotherapy combined with irreversible electroporation for stage IV Hepatocellular carcinoma: survival outcome. Cell Physiol Biochem 2018; 48: 1882-1893. https://doi.org/10.1159/000492509
  • YANG Y, QIN Z, DU D, WU Y, QIU S, MU F et al. Safety and short-term efficacy of irreversible electroporation and allogenic natural killer cell immunotherapy combination in the treatment of patients with unresectable primary liver cancer. Cardiovasc Intervent Radiol 2019; 42: 48-59. https://doi.org/10.1007/s00270-018-2069-y
  • SHI X, O'NEILL C, WANG X, CHEN Y, YU Y, TAN M et al. Irreversible electroporation enhances immunotherapeutic effect in the off-target tumor in a murine model of orthotopic HCC. Am J Cancer Res 2021; 11: 3304-3319. http://www.ncbi.nlm.nih.gov/pubmed/34249464
  • LLOVET JM, DE BAERE T, KULIK L, HABER PK, GRETEN TF, MEYER T, LENCIONI R. Locoregional therapies in the era of molecular and immune treatments for hepatocellular carcinoma. Nat Rev Gastroenterol Hepatol 2021; 18: 293-313. https://doi.org/10.1038/s41575-020-00395-0
  • ARELLANO RS. What’s new in percutaneous ablative strategies for hepatocellular carcinoma and colorectal hepatic metastases? 2020 Update. Curr Oncol Rep 2020; 22: 105. https://doi.org/10.1007/s11912-020-00967-y
  • VIVAS I, IRIBARREN K, LOZANO T, CANO D, LASARTE-CIA A, CHOCARRO S et al. Therapeutic effect of irreversible electroporation in combination with Poly-ICLC adjuvant in preclinical models of hepatocellular carcinoma. J Vasc Interv Radiol 2019; 30: 1098-1105. https://doi.org/10.1016/j.jvir.2019.02.023
  • LASARTE-CIA A, LOZANO T, CANO D, MARTÍN-OTAL C, NAVARRO F, GORRAIZ M et al. Intratumoral STING agonist injection combined with irreversible electroporation delays tumor growth in a model of hepatocarcinoma. Biomed Res Int 2021; 2021: 1-9. https://doi.org/10.1155/2021/8852233
Fuente de los datos: Dialnet