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Ledbetter D, de Almeida RAA, Wu X, Naveh A, Patel CB, Gonzalez Q, Beckham TH, North R, Rhines L, Li J, Ghia A, Aten D, Tatsui C, Alvarez-Breckenridge C. Tumor treating fields suppress tumor cell growth and neurologic decline in models of spinal metastases. JCI Insight 2024; 9:e176962. [PMID: 38512420 PMCID: PMC11141916 DOI: 10.1172/jci.insight.176962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/06/2024] [Indexed: 03/23/2024] Open
Abstract
Spinal metastases can result in severe neurologic compromise and decreased overall survival. Despite treatment advances, local disease progression is frequent, highlighting the need for novel therapies. Tumor treating fields (TTFields) impair tumor cell replication and are influenced by properties of surrounding tissue. We hypothesized that bone's dielectric properties will enhance TTFields-mediated suppression of tumor growth in spinal metastasis models. Computational modeling of TTFields intensity was performed following surgical resection of a spinal metastasis and demonstrated enhanced TTFields intensity within the resected vertebral body. Additionally, luciferase-tagged human KRIB osteosarcoma and A549 lung adenocarcinoma cell lines were cultured in demineralized bone grafts and exposed to TTFields. Following TTFields exposure, the bioluminescence imaging (BLI) signal decreased to 10%-80% of baseline, while control cultures displayed a 4.48- to 9.36-fold increase in signal. Lastly, TTFields were applied in an orthotopic murine model of spinal metastasis. After 21 days of treatment, control mice demonstrated a 5-fold increase in BLI signal compared with TTFields-treated mice. TTFields similarly prevented tumor invasion into the spinal canal and development of neurologic symptoms. Our data suggest that TTFields can be leveraged as a local therapy within minimally conductive bone of spinal metastases. This provides the groundwork for future studies investigating TTFields for patients with treatment-refractory spinal metastases.
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Affiliation(s)
- Daniel Ledbetter
- Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Xizi Wu
- Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | | | - Queena Gonzalez
- Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Robert North
- Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Laurence Rhines
- Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jing Li
- Department of Radiation Oncology, CNS/Pediatrics Section, and
| | - Amol Ghia
- Department of Radiation Oncology, CNS/Pediatrics Section, and
| | - David Aten
- Department of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Claudio Tatsui
- Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Tatsui CE, Carlson KW, Patel CB. Tumor treating fields (TTFields) for spinal metastasis-The case for bone removal and spinal implants as waveguides to enhance field strength at the target. Neurooncol Adv 2024; 6:vdad170. [PMID: 38288093 PMCID: PMC10824159 DOI: 10.1093/noajnl/vdad170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024] Open
Affiliation(s)
- Claudio E Tatsui
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Chirag B Patel
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Moreddu R. Nanotechnology and Cancer Bioelectricity: Bridging the Gap Between Biology and Translational Medicine. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2304110. [PMID: 37984883 PMCID: PMC10767462 DOI: 10.1002/advs.202304110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/25/2023] [Indexed: 11/22/2023]
Abstract
Bioelectricity is the electrical activity that occurs within living cells and tissues. This activity is critical for regulating homeostatic cellular function and communication, and disruptions of the same can lead to a variety of conditions, including cancer. Cancer cells are known to exhibit abnormal electrical properties compared to their healthy counterparts, and this has driven researchers to investigate the potential of harnessing bioelectricity as a tool in cancer diagnosis, prognosis, and treatment. In parallel, bioelectricity represents one of the means to gain fundamental insights on how electrical signals and charges play a role in cancer insurgence, growth, and progression. This review provides a comprehensive analysis of the literature in this field, addressing the fundamentals of bioelectricity in single cancer cells, cancer cell cohorts, and cancerous tissues. The emerging role of bioelectricity in cancer proliferation and metastasis is introduced. Based on the acknowledgement that this biological information is still hard to access due to the existing gap between biological findings and translational medicine, the latest advancements in the field of nanotechnologies for cellular electrophysiology are examined, as well as the most recent developments in micro- and nano-devices for cancer diagnostics and therapy targeting bioelectricity.
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Li X, Liu K, Xing L, Rubinsky B. A review of tumor treating fields (TTFields): advancements in clinical applications and mechanistic insights. Radiol Oncol 2023; 57:279-291. [PMID: 37665740 PMCID: PMC10476910 DOI: 10.2478/raon-2023-0044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/04/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Tumor Treating Fields (TTFields) is a non-invasive modality for cancer treatment that utilizes a specific sinusoidal electric field ranging from 100 kHz to 300 kHz, with an intensity of 1 V/cm to 3 V/cm. Its purpose is to inhibit cancer cell proliferation and induce cell death. Despite promising outcomes from clinical trials, TTFields have received FDA approval for the treatment of glioblastoma multiforme (GBM) and malignant pleural mesothelioma (MPM). Nevertheless, global acceptance of TTFields remains limited. To enhance its clinical application in other types of cancer and gain a better understanding of its mechanisms of action, this review aims to summarize the current research status by examining existing literature on TTFields' clinical trials and mechanism studies. CONCLUSIONS Through this comprehensive review, we seek to stimulate novel ideas and provide physicians, patients, and researchers with a better comprehension of the development of TTFields and its potential applications in cancer treatment.
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Affiliation(s)
- Xing Li
- College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nan Jing, Jiang Su, China
| | - Kaida Liu
- College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nan Jing, Jiang Su, China
| | - Lidong Xing
- College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nan Jing, Jiang Su, China
| | - Boris Rubinsky
- Department of Mechanical Engineering, University of California Berkeley, BerkeleyCA, United States of America
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