中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 40 Issue 11
Nov.  2024
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2024  >  40(11): 2277-2282

Efficacy and safety of irreversible electroporation combined with immunotherapy in treatment of unresectable pancreatic cancer： A Meta-analysis

DOI: 10.12449/JCH241122
  • 1.

    The First Clinical Medical College of Shanxi Medical University，Taiyuan 030000，China

  • 2.

    Department of Hepatobiliary and Pancreatic Surgery，The First Hospital of Shanxi Medical University，Taiyuan 030000，China

More Information
  • Corresponding author: LIU Jiansheng， 147542533@qq.com （ORCID： 0000-0002-6038-2560）
  • Received Date: 2024-03-07
  • Accepted Date: 2024-04-16
  • Published Date: 2024-11-25
    Abstract
  •   Objective  To systematically review the safety and efficacy of irreversible electroporation （IRE） combined with immunotherapy in patients with unresectable pancreatic cancer.  Methods  This study was conducted according to the PRISMA guideline， with a PROSPERO registration unmber of CRD42024531984. Datebases including PubMed， Embase the Cochrane Library， Web of Science， CNKI， Wanfang Data， and VIP were searched for related articles on IRE combined with immunotherapy for unresectable pancreatic cancer published up to February 2024. The articles were screened and related data were extracted according to the established inclusion and exclusion criteria， and the quality of the articles was assessed. Review Manager 5.3 and Stata 17.0 software were used to perform the meta-analysis.  Results  Six studies were finally included， with three prospective studies， two retrospective studies， and one randomized controlled trial. There were 376 patients with unresectable pancreatic cancer in total， among whom there were 222 patients in the IRE group and 154 patients in the IRE+immunotherapy group. The meta-analysis showed that compared with IRE alone， IRE combined with immunotherapy significantly prolonged progression-free survival （hazard ratio ［HR］=0.82， 95% confidence interval ［CI］： 0.72 ‍—‍ 0.92， P=0.001） and overall survival （HR=0.86， 95%CI： 0.80 ‍—‍ 0.93， P=0.000 1）， increased T lymphocyte count in the patients （mean difference=217.93， 95%CI： 192.87 ‍—‍ 242.99， P<0.000 01）， and improved the immune function of patients. However， there were no significant differences between the two groups in reducing the incidence rate of adverse events （odds ratio ［OR］=1.43， 95%CI： 0.76 ‍—‍ 2.72， P=0.27） and improving the objective remission rate of patients （OR=1.49， 95%CI： 0.87 ‍—‍ 2.56， P=0.15）.  Conclusion  IRE combined with immunotherapy is safe and effective in patients with unresectable pancreatic cancer and can significantly improve overall survival and progression-free survival and enhance immune function， with little effect on objective remission rate and the incidence rate of adverse events.

     

    • FullText(HTML)
  • loading
    • References(33)
  • [1]
    CAI J, CHEN HD, LU M, et al. Trend analysis on morbidity and mortality of pancreatic cancer in China, 2005-2015[J]. Chin J Epidemiol, 2021, 42( 5): 794- 800. DOI: 10.3760/cma.j.cn112338-20201115-01328.

    蔡洁, 陈宏达, 卢明, 等. 2005—2015年中国胰腺癌发病与死亡趋势分析[J]. 中华流行病学杂志, 2021, 42( 5): 794- 800. DOI: 10.3760/cma.j.cn112338-20201115-01328.
    [2]
    TEMPERO MA, MALAFA MP, AL-HAWARY M, et al. Pancreatic adenocarcinoma, version 2.2021, NCCN clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw, 2021, 19( 4): 439- 457. DOI: 10.6004/jnccn.2021.0017.
    [3]
    GEBOERS B, TIMMER FEF, RUARUS AH, et al. Irreversible electroporation and nivolumab combined with intratumoral administration of a toll-like receptor ligand, as a means of in vivo vaccination for metastatic pancreatic ductal adenocarcinoma(PANFIRE-III). A phase-I study protocol[J]. Cancers, 2021, 13( 15): 3902. DOI: 10.3390/cancers13153902.
    [4]
    TIMMER FEF, GEBOERS B, RUARUS AH, et al. Irreversible electroporation for locally advanced pancreatic cancer[J]. Tech Vasc Interv Radiol, 2020, 23( 2): 100675. DOI: 10.1016/j.tvir.2020.100675.
    [5]
    KWON W, THOMAS A, KLUGER MD. Irreversible electroporation of locally advanced pancreatic cancer[J]. Semin Oncol, 2021, 48( 1): 84- 94. DOI: 10.1053/j.seminoncol.2021.02.004.
    [6]
    DANG XD. Therapeutic effect analysis of irreversible electroporation for pancreatic cancer and preliminary exploration of combined therapy[D]. Yan’an: Yan’an University, 2023.

    党旭东. 不可逆电穿孔治疗胰腺癌疗效分析及联合治疗应用初步探索[D]. 延安: 延安大学, 2023.
    [7]
    TIMMER FEF, GEBOERS B, NIEUWENHUIZEN S, et al. Pancreatic cancer and immunotherapy: A clinical overview[J]. Cancers, 2021, 13( 16): 4138. DOI: 10.3390/cancers13164138.
    [8]
    HE CB, WANG J, SUN SX, et al. Immunomodulatory effect after irreversible electroporation in patients with locally advanced pancreatic cancer[J]. J Oncol, 2019, 2019: 9346017. DOI: 10.1155/2019/9346017.
    [9]
    PANDIT H, HONG YK, LI Y, et al. Evaluating the regulatory immunomodulation effect of irreversible electroporation(IRE) in pancreatic adenocarcinoma[J]. Ann Surg Oncol, 2019, 26( 3): 800- 806. DOI: 10.1245/s10434-018-07144-3.
    [10]
    SCHEFFER HJ, STAM AGM, GEBOERS B, et al. Irreversible electroporation of locally advanced pancreatic cancer transiently alleviates immune suppression and creates a window for antitumor T cell activation[J]. Oncoimmunology, 2019, 8( 11): 1652532. DOI: 10.1080/2162402X.2019.1652532.
    [11]
    WELLS G, SHEA BJ, O’CONNELL D, et al. The Newcastle-Ottawa Scale(NOS) for assessing the quality of nonrandomized studies in Meta-analyses[EB/OL].( 2021-05-03). http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
    [12]
    LIN M, ALNAGGAR M, LIANG SZ, et al. An important discovery on combination of irreversible electroporation and allogeneic natural killer cell immunotherapy for unresectable pancreatic cancer[J]. Oncotarget, 2017, 8( 60): 101795- 101807. DOI: 10.18632/oncotarget.21974.
    [13]
    LIN M, LIANG SZ, WANG XH, et al. Short-term clinical efficacy of percutaneous irreversible electroporation combined with allogeneic natural killer cell for treating metastatic pancreatic cancer[J]. Immunol Lett, 2017, 186: 20- 27. DOI: 10.1016/j.imlet.2017.03.018.
    [14]
    LIN M, ZHANG XY, LIANG SZ, et al. Irreversible electroporation plus allogenic Vγ9Vδ2 T cells enhances antitumor effect for locally advanced pancreatic cancer patients[J]. Signal Transduct Target Ther, 2020, 5( 1): 215. DOI: 10.1038/s41392-020-00260-1.
    [15]
    PAN QH, HU CG, FAN YH, et al. Efficacy of irreversible electroporation ablation combined with natural killer cells in treating locally advanced pancreatic cancer[J]. J BUON, 2020, 25( 3): 1643- 1649.
    [16]
    HE CB, SUN SX, ZHANG Y, et al. Irreversible electroporation plus anti-PD-1 antibody versus irreversible electroporation alone for patients with locally advanced pancreatic cancer[J]. J Inflamm Res, 2021, 14: 4795- 4807. DOI: 10.2147/JIR.S331023.
    [17]
    ZHANG T, LI XY, CHEN YJ, et al. Clinical efficacy of IRE ablation combined with PD-1 inhibitor and chemotherapy in treatment of locally advanced pancreatic cancer[J]. J Pract Med, 2023, 39( 9): 1153- 1158. DOI: 10.3969/j.issn.1006-5725.2023.09.016.

    张通, 李晓勇, 陈艳军, 等. 不可逆电穿孔消融术联合程序性死亡蛋白-1抑制剂及化疗在局部进展期胰腺癌的临床疗效[J]. 实用医学杂志, 2023, 39( 9): 1153- 1158. DOI: 10.3969/j.issn.1006-5725.2023.09.016.
    [18]
    RUARUS AH, VROOMEN LGPH, PUIJK RS, et al. Irreversible electroporation in hepatopancreaticobiliary tumours[J]. Can Assoc Radiol J, 2018, 69( 1): 38- 50. DOI: 10.1016/j.carj.2017.10.005.
    [19]
    GUPTA P, MARALAKUNTE M, SAGAR S, et al. Efficacy and safety of irreversible electroporation for malignant liver tumors: A systematic review and meta-analysis[J]. Eur Radiol, 2021, 31( 9): 6511- 6521. DOI: 10.1007/s00330-021-07742-y.
    [20]
    ONG S, LEONARDO M, CHENGODU T, et al. Irreversible electroporation for prostate cancer[J]. Life(Basel), 2021, 11( 6): 490. DOI: 10.3390/life11060490.
    [21]
    FAIELLA E, SANTUCCI D, VERTULLI D, et al. Irreversible electroporation(IRE) for prostate cancer(PCa) treatment: The state of the art[J]. J Pers Med, 2024, 14( 2): 137. DOI: 10.3390/jpm14020137.
    [22]
    RINGEL-SCAIA VM, BEITEL-WHITE N, LORENZO MF, et al. High-frequency irreversible electroporation is an effective tumor ablation strategy that induces immunologic cell death and promotes systemic anti-tumor immunity[J]. EBioMedicine, 2019, 44: 112- 125. DOI: 10.1016/j.ebiom.2019.05.036.
    [23]
    KIZY S, BAEZ H, GABER O, et al. Immunomodulation after irreversible electroporation for locally advanced pancreatic cancer: A Meta-analysis and institutional series[J]. Annals of Surgical Oncology, 2022, 29( Suppl 2): S444- S445.
    [24]
    ERDEM S, NARAYANAN JS, WORNI M, et al. Local ablative therapies and the effect on antitumor immune responses in pancreatic cancer-A review[J]. Heliyon, 2024, 10( 1): e23551. DOI: 10.1016/j.heliyon.2023.e23551.
    [25]
    FEIG C, GOPINATHAN A, NEESSE A, et al. The pancreas cancer microenvironment[J]. Clin Cancer Res, 2012, 18( 16): 4266- 4276. DOI: 10.1158/1078-0432.CCR-11-3114.
    [26]
    THIND K, PADRNOS LJ, RAMANATHAN RK, et al. Immunotherapy in pancreatic cancer treatment: A new frontier[J]. Therap Adv Gastroenterol, 2017, 10( 1): 168- 194. DOI: 10.1177/1756283X16667909.
    [27]
    O’NEILL C, HAYAT T, HAMM J, et al. A phase 1b trial of concurrent immunotherapy and irreversible electroporation in the treatment of locally advanced pancreatic adenocarcinoma[J]. Surgery, 2020, 168( 4): 610- 616. DOI: 10.1016/j.surg.2020.04.057.
    [28]
    BHUTIANI N, AGLE S, LI Y, et al. Irreversible electroporation enhances delivery of gemcitabine to pancreatic adenocarcinoma[J]. J Surg Oncol, 2016, 114( 2): 181- 186. DOI: 10.1002/jso.24288.
    [29]
    HE CB, HUANG X, ZHANG Y, et al. Comparison of survival between irreversible electroporation followed by chemotherapy and chemotherapy alone for locally advanced pancreatic cancer[J]. Front Oncol, 2020, 10: 6. DOI: 10.3389/fonc.2020.00006.
    [30]
    ZHAO BY, LIANG ZJ, ZHANG LX, et al. Safety and efficacy of irreversible electroporation combined with neoadjuvant chemotherapy for locally advanced pancreatic cancer: A meta-analysis[J]. Cancer Res Prev Treat, 2022, 49( 11): 1139- 1145. DOI: 10.3971/j.issn.1000-8578.2022.22.0367.

    赵宝银, 梁昭君, 张丽霞, 等. 不可逆电穿孔术联合新辅助化疗治疗局部进展期胰腺癌安全性和有效性的Meta分析[J]. 肿瘤防治研究, 2022, 49( 11): 1139- 1145. DOI: 10.3971/j.issn.1000-8578.2022.22.0367.
    [31]
    GEBOERS B, SCHEFFER HJ, GRAYBILL PM, et al. High-voltage electrical pulses in oncology: Irreversible electroporation, electrochemotherapy, gene electrotransfer, electrofusion, and electroimmunotherapy[J]. Radiology, 2020, 295( 2): 254- 272. DOI: 10.1148/radiol.2020192190.
    [32]
    CHEN BT, MAO XH. Clinical research advance in immunotherapy of pancreatic cancer[J]. Chin J Dig Surg, 2023, 22( 5): 610- 615. DOI: 10.3760/cma.j.cn115610-20230407-00158.

    陈博滔, 毛先海. 胰腺癌免疫治疗临床研究进展[J]. 中华消化外科杂志, 2023, 22( 5): 610- 615. DOI: 10.3760/cma.j.cn115610-20230407-00158.
    [33]
    FINCHAM REA, DELVECCHIO FR, GOULART MR, et al. Natural killer cells in pancreatic cancer stroma[J]. World J Gastroenterol, 2021, 27( 24): 3483- 3501. DOI: 10.3748/wjg.v27.i24.3483.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(6)  / Tables(1)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (96) PDF downloads(19) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return