Williams Cancer Institute

Cryoablation versus pulsed electrical field for the trearment of cancer

One important aspect to explain is the difference between pulse electric fields and cryoblation. This cryoblation consists of inserting a needle into the tumors and thus freezing them. Of course, different technologies are used such us argon gas and liquid nitrogen. These are techniques to cause the needle to freeze which in turn freezes the tumor. The process of freezing cracks and breaks the cell membrane. Cells break apart and leave pieces; these pieces help stimulate the immune system.

Likewise, pulsed electrical field (PEF) technology uses an electrical charge, this is discharged very quickly, in a nanosecond. This causes pores to develop in the cell membrane and organelles of the cells. Trough these pores, ions such as calcium rush in a cause cell death. This has no thermal effects so all of the pieces are left intact to be seen by the immune system. Essential more evidence has been left behind for the immune system to catch the criminals.

Cryoablation has a lot of variability in the immune response and can even be suppressive in some cases. PEF seems to be more consistently immune stimulating. In addition, an interesting aspect in most of these ablations is for advanced cancer, it is not necessary to ablate the entire tumor. If the entire tumor is ablated, much of the immune response is lost, this is important for advanced cases where an immune response is critical. In early stage cases your goal is still to destroy the entire tumor like a surgical removal. But if you’re looking to treat advanced cancer and elicit an immune response, it’s a partial ablation that is most effective. This is counter intuitive. This requires great expertise and can be considered an art, especially in cryoablation. Similarly, in many studies in both animals and humans, administration of immunotherapy into the ablation site has been shown to be more effective in generating an immune response. Intratumoral immunotherapy allows for more drug combinations which is needed for many cancers. Cancer treatments are evolving at a rapid pace and the cure has never been closer.

Reference: Erinjeri, J. P., & Clark, T. W. (2010). Cryoablation: mechanism of action and devices. Journal of Vascular and Interventional Radiology, 21(8), S187-S191. Nuccitelli, R. (2019). Application of pulsed electric fields to cancer therapy. Bioelectricity, 1(1), 30-34.

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