In secondary bone cancer, diseased cells break away from their original location, spreading to the bones. They are difficult to find, necessitating scans or biopsies, and cause debilitating pain. Spinal tumours are known to be the most painful. Currently, patients are treated with therapies, such as radiation therapy or surgery, combined with pain relief medication. However, 20-30 % of patients do not respond to this. EU support has enabled the APAC project to continue research and development into their Dynamic-ElectroEnhanced Pain Control™ (D-EEPC) system, to treat metastasis in the spine and bones. D-EEPC, developed by ChemoTech, which hosted the project, sends short, tumour-specific electric pulses in combination with a very low dose of a cancer-destroying drug. This reduces tumour size and alleviates pressure on the nerves, the cause of the severe pain. The pulses render the cancer cells more permeable making it easier for the drugs to enter. The tumour-specific pulses and electrodes can be altered, in response to the tumour’s size and location. Two patents have already been secured for the D-EEPC features that ensure its treatment is gentle and less destructive to spinal cord nerves and healthy tissue.
Electroporation for the targeted delivery of anti-cancer drugs
As secondary, stage IV cancer usually cannot be cured, treatment focusses on control of its development and palliative care. But most current options such as radiotherapy, chemotherapy and surgery are problematic as they can seldom be repeated if cancer returns and they are often inefficient. Invasive intervention, which is costly, can lead to side effects or additional complications, such as bleeding or infection. D-EEPC uses a drill electrode which is inserted into the vertebrae, using fluoroscopic or ultrasound navigation. This emits short, high-voltage electric pulses combined with low concentrations of cancer-destroying drugs such as Bleomycin or Cis-Platin. Sensors indicate when the probe is correctly positioned. “The combination of the electric pulses and drugs reduces tumour size in the spine and bones. As the treatment is minimally invasive it can be done under general anaesthetic in a polyclinic as a day procedure,” explains Mohan Stefan Frick, CEO and responsible for R&D at ChemoTech. Tests were conducted with two patients in Chennai, India. In the first, the patient’s pain was reduced and did not return to its previously high level going down from 10 to 3 using the visual analogue scale. There were no observable side effects and PET scans also showed a reduction in tumour size. In the second, a patient with breast cancer and skeletal metastases in the D9-D10 vertebrae and the left pubic bone was treated with Bleomycin and electroporation. The pain was then assessed over a 2-year period. It had significantly reduced from the maximum of 10 on the scale to 3 within a week of treatment.
Less invasive and more cost-effective
D-EEPC is intended to complement Radio Frequency (RF) heating therapy and radiotherapy, the two current state-of-the-art treatments to alleviate back pain caused by spinal tumour metastases. The system is maintained within IQwave™, ChemoTech’s patented treatment platform, which the team are working to get CE-marked, a requirement before clinical trials can start in the EU. “So far the system has been shown to be more promising than we first thought. After performing more than 200 treatments in India and South-East Asia, using ChemoTech’s first electroporation product IQwave™, we have seen encouraging indications that it can be used to perform the D-EEPC therapy,” says Frick. The team are currently seeking further EU funds to start the clinical trials.
APAC, bone cancer, spinal, nerves, cancer, tumour, pain, Radio Frequency, electric pulse, probe, electroporation