Zhang Zigeng, Yu Guangbo, Eresen Aydin, Chen Zhilin, Yu Zeyang, Yaghmai Vahid, Zhang Zhuoli
Department of Radiological Sciences, University of California Irvine, Irvine, CA, USA.
Department of Biomedical Engineering, University of California Irvine, Irvine, CA, USA.
Ann Transl Med. 2024 Aug 1;12(4):77. doi: 10.21037/atm-23-1882. Epub 2024 May 28.
Pancreatic ductal adenocarcinoma (PDAC) is 3 most lethal cancer in the USA leading to a median survival of six months and less than 5% 5-year overall survival (OS). As the only potentially curative treatment, surgical resection is not suitable for up to 90% of the patients with PDAC due to late diagnosis. Highly fibrotic PDAC with an immunosuppressive tumor microenvironment restricts cytotoxic T lymphocyte (CTL) infiltration and functions causing limited success with systemic therapies like dendritic cell (DC)-based immunotherapy. In this study, we investigated the potential benefits of irreversible electroporation (IRE) ablation therapy in combination with DC vaccine therapy against PDAC.
We performed a literature search to identify studies focused on DC vaccine therapy and IRE ablation to boost therapeutic response against PDAC indexed in PubMed, Web of Science, and Scopus until February 20, 2023.
IRE ablation destructs tumor structure while preserving extracellular matrix and blood vessels facilitating local inflammation. The studies demonstrated IRE ablation reduces tumor fibrosis and promotes CTL tumor infiltration to PDAC tumors in addition to boosting immune response in rodent models. The administration of the DC vaccine following IRE ablation synergistically enhances therapeutic response and extends OS rates compared to the use of DC vaccination or IRE alone. Moreover, the implementation of data-driven approaches further allows dynamic and longitudinal monitoring of therapeutic response and OS following IRE plus DC vaccine immunoablation.
The combination of IRE ablation and DC vaccine immunotherapy is a potent strategy to enhance the therapeutic outcomes in patients with PDAC.
胰腺导管腺癌（PDAC）是美国致死率最高的癌症之一，中位生存期为6个月，5年总生存率（OS）低于5%。作为唯一可能治愈的治疗方法，由于诊断较晚，手术切除不适用于高达90%的PDAC患者。具有免疫抑制肿瘤微环境的高度纤维化PDAC会限制细胞毒性T淋巴细胞（CTL）的浸润和功能，导致基于树突状细胞（DC）的免疫疗法等全身治疗效果有限。在本研究中，我们调查了不可逆电穿孔（IRE）消融疗法联合DC疫苗疗法治疗PDAC的潜在益处。
我们进行了文献检索，以确定截至2023年2月20日在PubMed、科学网和Scopus上索引的专注于DC疫苗疗法和IRE消融以增强对PDAC治疗反应的研究。
IRE消融破坏肿瘤结构，同时保留细胞外基质和血管，促进局部炎症。研究表明，IRE消融除了在啮齿动物模型中增强免疫反应外，还可减少肿瘤纤维化并促进CTL向PDAC肿瘤浸润。与单独使用DC疫苗接种或IRE相比，IRE消融后给予DC疫苗可协同增强治疗反应并延长OS率。此外，数据驱动方法的实施进一步允许对IRE联合DC疫苗免疫消融后的治疗反应和OS进行动态和纵向监测。
IRE消融与DC疫苗免疫疗法相结合是提高PDAC患者治疗效果的有效策略。
