Immunological Response During Electroporation

Abstract

Minimally invasive energy-based ablation techniques such as radiofrequency ablation, cryoablation, and irreversible electroporation are now widely used for treatment of a variety of malignant lesions. An unexpected but interesting sequel of such ablation methods has been regression of untreated distant metastases following ablation of the primary lesion. This phenomenon has been fairly studied following ablation with hypo- and hyperthermal modalities, especially cryoablation, and is mostly ascribed to an adaptive antitumor immune response induced by release of significant quantities of normally inaccessible tumor anti- gens from the damaged tissue. Irreversible electroporation is a new, nonthermal ablation technology that because of its unique characteristics is hypothesized to be capable of inciting a strong tumor-specific adaptive immune response. How- ever, very limited information regarding existence, extent, and efficacy of such immune response is available in the literature. Therefore, based on literature pertaining to other energy-based techniques, this chapter first provides a brief summary of mechanisms proposed to be involved in the interaction between immune system and tissue ablation methods. Then, data from studies investigat- ing the local and systemic immune response following IRE will be presented and analyzed.