REPETITIVE RFA IN INOPERABLE PANCREATIC CANCER PATIENTS

REPETITIVE RFA IN INOPERABLE PANCREATIC CANCER PATIENTS

Authors

  • NINO TORIA Department of Immunology, Tbilisi State Medical University, Department of Interventional Radiology; Tbilisi State Medical University, Tbilisi, Georgia
  • MALKHAZ MIZANDARI Department of Immunology, Tbilisi State Medical University, Department of Interventional Radiology; Tbilisi State Medical University, Tbilisi, Georgia
  • TINATIN CHIKOVANI Department of Immunology, Tbilisi State Medical University, Department of Interventional Radiology; Tbilisi State Medical University, Tbilisi, Georgia

DOI:

https://doi.org/10.52340/jecm.2022.06.05

Abstract

Pancreatic cancer remains a leading cause of cancer-related mortality. Negligible success in testing various therapeutic approaches is explained by an advanced stage of the tumor at the diagnosis when clinical symptoms start to present. Immunosuppressive and dense stroma is mainly responsible for rapid growth and insidious spread of pancreatic cancer and also for resistance to various treatments. Reconsidering existing treatment protocols to establish personalized approaches to each patient’s case seems yet to be an only rational strategy. The radiofrequency ablation (RFA) technique as a minimally invasive loco-regional therapy has widespread popularity due to the possibility of tumor eradication together with positive immune-modulation effects in many cancers. However, this effect declines from time to time. To maintain the effect, we performed 3 repetitive RFAs in the patients with inoperable pancreatic cancer. According to our study RFA is a safe and feasible procedure. Repetitive RFA can be used in combination treatment and as a bridge between local and systemic cancer treatments. Booster application of RFA procedure might be a promising option to improve survival rates in patients with pancreatic cancer.

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References

Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72: 7–33.

Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70: 7–30.

Sohal DPS, Kennedy EB, Cinar P, Conroy T, Copur MS, Crane CH, et al. Metastatic Pancreatic Cancer: ASCO Guideline Update. J Clin Oncol. 2020; JCO2001364.

van Dam JL, Janssen QP, Besselink MG, Homs MYV, van Santvoort HC, van Tienhoven G, et al. Neoadjuvant therapy or upfront surgery for resectable and borderline resectable pancreatic cancer: A meta-analysis of randomised controlled trials. Eur J Cancer. 2022;160: 140–149.

Ghaneh P, Palmer DH, Cicconi S, Halloran C, Psarelli EE, Rawcliffe CL, et al. ESPAC-5F: Four-arm, prospective, multicenter, international randomized phase II trial of immediate surgery compared with neoadjuvant gemcitabine plus capecitabine (GEMCAP) or FOLFIRINOX or chemoradiotherapy (CRT) in patients with borderline resectable pancreatic cancer. J Clin Orthod. 2020;38: 4505–4505.

Carlos Fernandez-del Castillo, MDRamon E Jimenez, MDJanet E Murphy, MD, MPH. Supportive care of the patient with locally advanced or metastatic exocrine pancreatic cancer. Savarese DMF, editor. UpToDate; 2021.

Adamska A, Domenichini A, Falasca M. Pancreatic Ductal Adenocarcinoma: Current and Evolving Therapies. Int J Mol Sci. 2017;18. doi:10.3390/ijms18071338

Timmer FEF, Geboers B, Nieuwenhuizen S, Dijkstra M, Schouten EAC, Puijk RS, et al. Pancreatic Cancer and Immunotherapy: A Clinical Overview. Cancers. 2021;13. doi:10.3390/cancers13164138

Mucciolo G, Roux C, Scagliotti A, Brugiapaglia S, Novelli F, Cappello P. The dark side of immunotherapy: pancreatic cancer. Cancer Drug Resistance. 2020;3: 491–520.

Tempero MA, Malafa MP, Al-Hawary M, Behrman SW, Benson AB, Cardin DB, et al. Pancreatic Adenocarcinoma, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2021;19: 439–457.

Geboers B, Ruarus AH, Nieuwenhuizen S, Puijk RS, Scheffer HJ, de Gruijl TD, et al. Needle-guided ablation of locally advanced pancreatic cancer: cytoreduction or immunomodulation by in vivo vaccination? Chin Clin Oncol. 2019;8: 61.

Kudo M. Immuno-Oncology in Hepatocellular Carcinoma: 2017 Update. Oncology. 2017;93 Suppl 1: 147–159.

Yu P, Rowley DA, Fu Y-X, Schreiber H. The role of stroma in immune recognition and destruction of well-established solid tumors. Curr Opin Immunol. 2006;18: 226–231.

Liu Y, Dong Y, Kong L, Shi F, Zhu H, Yu J. Abscopal effect of radiotherapy combined with immune checkpoint inhibitors. J Hematol Oncol. 2018;11: 104.

Faraoni EY, Thosani NC, O’Brien B, Strickland LN, Mota V, Chaney J, et al. Radiofrequency ablation remodels the tumor microenvironment and promotes systemic immunomodulation in pancreatic cancer. bioRxiv. 2022. p. 2022.01.07.475451. doi:10.1101/2022.01.07.475451

Fei Q, Pan Y, Lin W, Zhou Y, Yu X, Hou Z, et al. High-dimensional single-cell analysis delineates radiofrequency ablation induced immune microenvironmental remodeling in pancreatic cancer. Cell Death Dis. 2020;11: 589.

Bhardwaj N, Dormer J, Ahmad F, Strickland AD, Gravante G, Beckingham I, et al. Heat shock protein 70 expression following hepatic radiofrequency ablation is affected by adjacent vasculature. J Surg Res. 2012;173: 249–257.

Kroemer G, Galluzzi L, Kepp O, Zitvogel L. Immunogenic cell death in cancer therapy. Annu Rev Immunol. 2013;31: 51–72.

Paiella S, Salvia R, Ramera M, Girelli R, Frigerio I, Giardino A, et al. Local Ablative Strategies for Ductal Pancreatic Cancer (Radiofrequency Ablation, Irreversible Electroporation): A Review. Gastroenterol Res Pract. 2016;2016: 4508376.

Mizandari M, Kumar J, Pai M, Chikovani T, Azrumelashvili T, Reccia I, et al. Interventional radiofrequency ablation: A promising therapeutic modality in the management of malignant biliary and pancreatic duct obstruction. J Cancer. 2018;9: 629–637.

Ma SJ, Prezzano KM, Hermann GM, Singh AK. Dose escalation of radiation therapy with or without induction chemotherapy for unresectable locally advanced pancreatic cancer. Radiation Oncology. 2018. doi:10.1186/s13014-018-1158-z

Lee Y-H, Yu C-F, Yang Y-C, Hong J-H, Chiang C-S. Ablative Radiotherapy Reprograms the Tumor Microenvironment of a Pancreatic Tumor in Favoring the Immune Checkpoint Blockade Therapy. Int J Mol Sci. 2021;22. doi:10.3390/ijms22042091

Janikashvili N, Kikodze N, Iobadze M, Mazmishvili K, Chikovani T. The Differential Effects of Radiofrequency Ablation and Hepatic Resection on Serum IL-10 Level in Patients with Liver Cancer. 2019;03. doi:10.26502/jcsct.5079028

Chen Z, Shen S, Peng B, Tao J. Intratumoural GM-CSF microspheres and CTLA-4 blockade enhance the antitumour immunity induced by thermal ablation in a subcutaneous murine hepatoma model. Int J Hyperthermia. 2009;25: 374–382.

Levy MY, Sidana A, Chowdhury WH, Solomon SB, Drake CG, Rodriguez R, et al. Cyclophosphamide unmasks an antimetastatic effect of local tumor cryoablation. J Pharmacol Exp Ther. 2009;330: 596–601.

Tempero MA, Malafa MP, Behrman SW, Benson AB 3rd, Casper ES, Chiorean EG, et al. Pancreatic adenocarcinoma, version 2.2014: featured updates to the NCCN guidelines. J Natl Compr Canc Netw. 2014;12: 1083–1093.

Tempero MA. NCCN Guidelines Updates: Pancreatic Cancer. J Natl Compr Canc Netw. 2019;17: 603–605.

Tas F, Sen F, Keskin S, Kilic L, Yildiz I. Prognostic factors in metastatic pancreatic cancer: Older patients are associated with reduced overall survival. Mol Clin Oncol. 2013;1: 788–792.

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Published

2022-06-02

How to Cite

NINO TORIA, MALKHAZ MIZANDARI, & TINATIN CHIKOVANI. (2022). REPETITIVE RFA IN INOPERABLE PANCREATIC CANCER PATIENTS. Experimental and Clinical Medicine Georgia, (4). https://doi.org/10.52340/jecm.2022.06.05

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