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Potentiation of the abscopal effect by modulated electro-hyperthermia in locally advanced cervical cancer patients

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Abstract
Background: A Phase III randomized controlled trial investigating the addition of modulated electro-hyperthermia (mEHT) to chemoradiotherapy for locally advanced cervical cancer patients is being conducted in South Africa (Human Research Ethics Committee approval: M1704133; ID: NCT03332069). Two hundred and ten participants were randomized and 202 participants were eligible for six month local disease control evaluation. Screening F-18-FDG PET/CT scans were conducted and repeated at six months post-treatment. Significant improvement in local control was reported in the mEHT group and complete metabolic resolution (CMR) of extra-pelvic disease was noted in some participants. We report on an analysis of the participants with CMR of disease inside and outside the radiation field. Method: Participants were included in this analysis if nodes outside the treatment field (FDG-uptake SUV>2.5) were visualized on pre-treatment scans and if participants were evaluated by F-18-FDG PET/CT scans at six months post-treatment. Results: One hundred and eight participants (mEHT: HIV-positive n = 25, HIV-negative n = 29; Control Group: HIV-positive n = 26, HIV-negative n = 28) were eligible for analysis. There was a higher CMR of all disease inside and outside the radiation field in the mEHT Group: n = 13 [24.1%] than the control group: n = 3 [5.6%] (Chi squared, Fisher's exact: p = 0.013) with no significant difference in the extra-pelvic response to treatment between the HIV-positive and -negative participants of each group. Conclusion: The CMR of disease outside the radiation field at six months post-treatment provides evidence of an abscopal effect which was significantly associated with the addition of mEHT to treatment protocols. This finding is important as the combined synergistic use of radiotherapy with mEHT could broaden the scope of radiotherapy to include systemic disease.
Keywords
modulated electro-hyperthermia, abscopal effect, radiotherapy, cervical cancer, immunomodulation, PET RESPONSE CRITERIA, CHEMOTHERAPY, PERCIST

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MLA
Minnaar, Carrie Anne, et al. “Potentiation of the Abscopal Effect by Modulated Electro-Hyperthermia in Locally Advanced Cervical Cancer Patients.” FRONTIERS IN ONCOLOGY, vol. 10, 2020, doi:10.3389/fonc.2020.00376.
APA
Minnaar, C. A., Kotzen, J., Ayeni, O., Vangu, M.-D.-T., & Baeyens, A. (2020). Potentiation of the abscopal effect by modulated electro-hyperthermia in locally advanced cervical cancer patients. FRONTIERS IN ONCOLOGY, 10. https://doi.org/10.3389/fonc.2020.00376
Chicago author-date
Minnaar, Carrie Anne, Jeffrey Kotzen, Olusegun Ayeni, Mboyo-Di-Tamba Vangu, and Ans Baeyens. 2020. “Potentiation of the Abscopal Effect by Modulated Electro-Hyperthermia in Locally Advanced Cervical Cancer Patients.” FRONTIERS IN ONCOLOGY 10. https://doi.org/10.3389/fonc.2020.00376.
Chicago author-date (all authors)
Minnaar, Carrie Anne, Jeffrey Kotzen, Olusegun Ayeni, Mboyo-Di-Tamba Vangu, and Ans Baeyens. 2020. “Potentiation of the Abscopal Effect by Modulated Electro-Hyperthermia in Locally Advanced Cervical Cancer Patients.” FRONTIERS IN ONCOLOGY 10. doi:10.3389/fonc.2020.00376.
Vancouver
1.
Minnaar CA, Kotzen J, Ayeni O, Vangu M-D-T, Baeyens A. Potentiation of the abscopal effect by modulated electro-hyperthermia in locally advanced cervical cancer patients. FRONTIERS IN ONCOLOGY. 2020;10.
IEEE
[1]
C. A. Minnaar, J. Kotzen, O. Ayeni, M.-D.-T. Vangu, and A. Baeyens, “Potentiation of the abscopal effect by modulated electro-hyperthermia in locally advanced cervical cancer patients,” FRONTIERS IN ONCOLOGY, vol. 10, 2020.
@article{8660532,
  abstract     = {Background: A Phase III randomized controlled trial investigating the addition of modulated electro-hyperthermia (mEHT) to chemoradiotherapy for locally advanced cervical cancer patients is being conducted in South Africa (Human Research Ethics Committee approval: M1704133; ID: NCT03332069). Two hundred and ten participants were randomized and 202 participants were eligible for six month local disease control evaluation. Screening F-18-FDG PET/CT scans were conducted and repeated at six months post-treatment. Significant improvement in local control was reported in the mEHT group and complete metabolic resolution (CMR) of extra-pelvic disease was noted in some participants. We report on an analysis of the participants with CMR of disease inside and outside the radiation field.

Method: Participants were included in this analysis if nodes outside the treatment field (FDG-uptake SUV>2.5) were visualized on pre-treatment scans and if participants were evaluated by F-18-FDG PET/CT scans at six months post-treatment.

Results: One hundred and eight participants (mEHT: HIV-positive n = 25, HIV-negative n = 29; Control Group: HIV-positive n = 26, HIV-negative n = 28) were eligible for analysis. There was a higher CMR of all disease inside and outside the radiation field in the mEHT Group: n = 13 [24.1%] than the control group: n = 3 [5.6%] (Chi squared, Fisher's exact: p = 0.013) with no significant difference in the extra-pelvic response to treatment between the HIV-positive and -negative participants of each group.

Conclusion: The CMR of disease outside the radiation field at six months post-treatment provides evidence of an abscopal effect which was significantly associated with the addition of mEHT to treatment protocols. This finding is important as the combined synergistic use of radiotherapy with mEHT could broaden the scope of radiotherapy to include systemic disease.},
  articleno    = {376},
  author       = {Minnaar, Carrie Anne and Kotzen, Jeffrey and Ayeni, Olusegun and Vangu, Mboyo-Di-Tamba and Baeyens, Ans},
  issn         = {2234-943X},
  journal      = {FRONTIERS IN ONCOLOGY},
  keywords     = {modulated electro-hyperthermia,abscopal effect,radiotherapy,cervical cancer,immunomodulation,PET RESPONSE CRITERIA,CHEMOTHERAPY,PERCIST},
  language     = {eng},
  pages        = {8},
  title        = {Potentiation of the abscopal effect by modulated electro-hyperthermia in locally advanced cervical cancer patients},
  url          = {http://dx.doi.org/10.3389/fonc.2020.00376},
  volume       = {10},
  year         = {2020},
}

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