Tissue Resistance Decrease during Irreversible Electroporation of Pancreatic Cancer as a Biomarker for the Adaptive Immune Response and Survival

Florentine E. F. Timmer, Bart Geboers, Hester J. Scheffer, Joyce Bakker, Alette H. Ruarus, Madelon Dijkstra, Susan van der Lei, Rianne Boon, Sanne Nieuwenhuizen, Bente A. T. van den Bemd, Evelien A. C. Schouten, Petrousjka M. van den Tol, Robbert S. Puijk, Jan J. J. de Vries, Tanja D. de Gruijl, Martijn R. Meijerink

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)

Abstract

Purpose: To correlate irreversible electroporation (IRE) procedural resistance changes with survival outcomes and the IRE-induced systemic immune response in patients with locally advanced pancreatic cancer (LAPC). Materials and Methods: Data on IRE procedural tissue resistance (R) features and survival outcomes were collected from patients with LAPC treated within the context of 2 prospective clinical trials in a single tertiary center. Preprocedural and postprocedural peripheral blood samples were prospectively collected for immune monitoring. The change (ie, decrease) in R during the first 10 test pulses (ΔR 10p) and during the total procedure (ΔR total) were calculated. Patients were divided in 2 groups on the basis of the median change in R (large ΔR vs small ΔR) and compared for differences in overall survival (OS) and progression-free survival and immune cell subsets. Results: A total of 54 patients were included; of these, 20 underwent immune monitoring. Linear regression modeling showed that the first 10 test pulses reflected the change in tissue resistance during the total procedure appropriately (P < .001; R 2 = 0.91). A large change in tissue resistance significantly correlated with a better OS (P = .026) and longer time to disease progression (P = .045). Furthermore, a large change in tissue resistance was associated with CD8 + T cell activation through significant upregulation of Ki-67 + (P = .02) and PD-1 + (P = .047). Additionally, this subgroup demonstrated significantly increased expression of CD80 on conventional dendritic cells (cDC1; P = .027) and PD-L1 on immunosuppressive myeloid-derived suppressor cells (P = .039). Conclusions: IRE procedural resistance changes may serve as a biomarker for survival and IRE-induced systemic CD8 + T cell and cDC1 activation.

Original languageEnglish
Pages (from-to)1777-1784.e4
JournalJournal of vascular and interventional radiology
Volume34
Issue number10
Early online date2023
DOIs
Publication statusPublished - Oct 2023

Cite this