Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
J Neurooncol. 2019 May;143(1):49-56. doi: 10.1007/s11060-019-03145-8. Epub 2019 Mar 9.
Diffuse intrinsic pontine glioma (DIPG) is a high fatality pediatric brain cancer without effective treatment. The field of electrotherapeutics offers new potential for other forms of glioma but the efficacy of this strategy has not been reported for DIPG. This pilot study evaluated the susceptibility of patient-derived DIPG cells to low intensity electric fields delivered using a developing technology called intratumoral modulation therapy (IMT).
DIPG cells from autopsy specimens were treated with a custom-designed, in vitro IMT system. Computer-generated electric field simulation was performed to quantify IMT amplitude and distribution using continuous, low intensity, intermediate frequency stimulation parameters. Treatment groups included sham, IMT, temozolomide (TMZ) chemotherapy and radiation therapy (RT). The impact of single and multi-modality therapy was compared using spectrophotometric and flow cytometry viability analyses.
DIPG cells exhibited robust, consistent susceptibility to IMT fields that significantly reduced cell viability compared to untreated control levels. The ratio of viable:non-viable DIPG cells transformed from ~ 6:1 in sham-treated to ~ 1.5:1 in IMT-treated conditions. The impact of IMT was similar to that of dual modality TMZ-RT therapy and the addition of IMT to this treatment combination dramatically reduced DIPG cell viability to ~ 20% of control values.
This proof-of-concept study provides a novel demonstration of marked DIPG cell susceptibility to low intensity electric fields delivered using IMT. The potent impact as a monotherapy and when integrated into multi-modality treatment platforms justifies further investigations into the potential of IMT as a critically needed biomedical innovation for DIPG.
弥漫性内在脑桥神经胶质瘤(DIPG)是一种高致死率的儿童脑癌,目前尚无有效的治疗方法。电疗领域为其他类型的神经胶质瘤提供了新的潜在治疗方法,但该策略对 DIPG 的疗效尚未见报道。这项初步研究评估了患者来源的 DIPG 细胞对使用称为肿瘤内调制治疗(IMT)的新兴技术进行的低强度电场的敏感性。
从尸检标本中分离出 DIPG 细胞,并用定制的体外 IMT 系统进行处理。使用连续的、低强度的中频刺激参数进行计算机生成的电场模拟,以量化 IMT 的幅度和分布。治疗组包括假手术组、IMT 组、替莫唑胺(TMZ)化疗组和放射治疗(RT)组。使用分光光度法和流式细胞术活力分析比较单模态和多模态治疗的影响。
DIPG 细胞对 IMT 场表现出强烈、一致的敏感性,与未经处理的对照水平相比,细胞活力显著降低。在假手术处理组中,存活的:非存活的 DIPG 细胞的比例约为 6:1,而在 IMT 处理组中则转变为约 1.5:1。IMT 的影响与 TMZ-RT 双重模式治疗相似,并且将 IMT 添加到该治疗组合中可将 DIPG 细胞的活力显著降低至对照值的约 20%。
这项概念验证研究为使用 IMT 传递的低强度电场对 DIPG 细胞的显著敏感性提供了新的证明。作为单一疗法的强大影响以及当其整合到多模态治疗平台中时, justifies 进一步研究 IMT 作为 DIPG 急需的生物医学创新的潜力。