Breast cancer is a major cause of cancer-related mortalities in women. Among the different subtypes of breast cancer, triple-negative breast cancer (TNBC) correlates with poor prognosis and worse survival due to early metastasis to other organs and lack of clinically established targeted therapies. Triple-negative breast cancer (TNBC) remains the most challenging type of breast cancer compared to other breast cancer subtypes. Tumor-associated macrophages (TAMs) are important tumor-promoting cells in the breast tumor microenvironment (TME). Macrophages account for approximately 30-50% of immune cells in the TME. TAMs are reported to enhance breast tumor progression, including, invasion, and metastasis. In addition, TAMs play a key role in developing therapy resistance in breast cancer models. TAMs also increase tumor angiogenesis and helps in creating an immunosuppressive TME. Macrophages are well known for their plastic nature, which is usually exploited by cancer cells that polarize classic macrophages (M1) to an immunosuppressive phenotype known as M2 TAMs and create a microenvironment to support tumor progression and metastasis.
Increased recruitment of TAMs correlates with a worse prognosis of breast tumors. The intervention strategies against TAMs could be a reduction of macrophage recruitment to tumors or altering their polarization from M2 TAMs to an antitumor M1 phenotype. TAMs regulate a wide array of functions in the TME including tumor invasion, metastasis, and immune responses. M2 TAMs have been shown to inhibit the infiltration and activation of CD8+ T cells in the TME. Tumor-reactive CD8+ T cells predominantly aid in the clearance of tumor cells. Notably, depletion of macrophages has been shown to improve the infiltration of CD8+ T cells, which underscores the impact of macrophages in impeding tumor immunity.
Non-contact induced electric fields (iEFs) generated by time-dependent magnetic fields produced by current-carrying coils driven at 100 kHz have been shown to selectively hinder the migration of highly metastatic breast cancer cells in vitro. Similar effects have been observed in vitro with other cells such as keratinocytes and murine wound macrophages. These iEFs have been shown in a direction-dependent manner, to either slow down or completely arrest some of the time, migrating cancer cells in microchannels mimicking the topography of preexisting paths formed by vessels, extracellular matrix fibers, and white matter tracts in the brain that guide migrating cancer cells in vivo. Further, this slowing down and arrest of migrating cancer cells has been shown to be associated with changes in metabolic activity. Specifically, iEFs lowered the activity of succinate dehydrogenase (SDH) selectively in vitro in highly metastatic MDA-MB-231 breast cancer cells while also selectively increasing the activity of lactate dehydrogenase (LDH) in non-transformed, normal MCF10A breast epithelial cells. SDH is a surrogate marker of oxidative phosphorylation that occurs in the mitochondria of cells and LDH is a surrogate marker of glycolysis that occurs in the cytoplasm of cells. These changes in metabolic activity also serve to explain previously reported changes in the actin cytoskeleton of these breast cancer cells, which is also linked to changes in metabolic activity leading to altered ATP production.
In addition to these previously reported in vitro results, there has been a recent report of the effects of electromagnetic fields on treating type 2 diabetes in mouse models. These demonstrate in diabetic mouse models the use of “static” (i.e., time-invariant or non-time dependent) electric and magnetic fields to modulate redox systems for the non-invasive treatment of type 2 diabetes. However, these do not teach that their vertically directed static electric field and laterally directed static magnetic field are not static at all. While it is true that they are static (steady) in the laboratory frame of reference, they are dynamic (time-varying) in the frame of reference of the mice as the mice move about inside the cage. In other words, with respect to the moving mice, the magnetic field appears to be changing with time and will therefore induce an electric field (effectively an iEF) in the mice whose magnitude and direction will depend on the velocity of the mice. This can be seen more succinctly in Faraday's law:
Numerous processes involved in cell migration including actomyosin contraction, focal adhesion point breaks, actin polymerization are known to be energy-intensive processes that rely primarily on mitochondrial respiration. Migration characteristics such as cell speed and net displacement are dependent on ATP:ADP ratio in a cell. While other energetic pathways such as glycolysis and pentose phosphate shunt also contribute to supplying the cell with energy, mitochondrial oxidative phosphorylation is the major contributor. Moreover, mitochondrial function also controls Ca2+ channels and reactive oxygen species generation, both of which act as secondary messengers in the pathways involved in cell migration, both in physiologically normal and cancer cells. Although conventionally considered glycolytic, most cancer cells meet their energy needs through mitochondrial function. Furthermore, the significance of the mitochondrial respiratory enzyme succinate dehydrogenase (SDH) (Complex II of the electron transport chain) is best appreciated when considering tumors bearing mutations in SDH. Several studies on MDA-MB-231 cells targeting mitochondrial fusion or fission have found a significant reduction in cell migration, invasion, and proliferation.
It has also recently been shown that oxidative phosphorylation in the mitochondria of metastatic breast cancer cells (MDA-MB-231) is suppressed by iEFs but not in the normal MCF10A breast epithelial cells. This has strong implications for hindering metastasis, which is an energy-intensive process. Though cancer cells are known to rely on other metabolic pathways such as glycolysis, fatty acid metabolism, and glutamine metabolism, they still rely primarily on oxidative phosphorylation to generate the energy required for metastasis. Therefore, iEFs can be effective in attacking the most energetic pathways that cancer cells use to metastasize to distant sites.
It is with respect to these and other considerations that the various aspects and embodiments of the present disclosure are presented.
This invention is directed to systems and methods that use induce electric fields or result in induced electric fields (iEFs) to control and hinder metastatic disease, such as invasive solid cancers.
In vitro and in vivo results to date indicate that iEF treatment can be used to control and hinder metastatic disease without any accompanying adverse effects. The translation of iEF treatment to higher animals and humans can potentially be enabled in several forms.
An implementation for treatment involves an external, portable induction coil with its associated power source. The patient continuously (or for a predetermined duration) wears the external power supply and iEF coil until treatment is completed as determined by standard diagnostic techniques (CT scans, PET scans, ultrasound, biopsy, etc.).
Another implementation is the coil generating the iEF (and its associated power supply) being an integral part of a fabric worn by the patient.
Yet another implementation involves iEF generating coils embedded in a mattress (or other pieces of furniture or objects), on which a patient would sleep or rest.
Yet another implementation is where the coil is an imprinted metallic shape on a fabric (e.g., silk) substrate or dressing.
It is contemplated that iEF cancer treatment will be free of harmful side effects such as those associated with chemotherapy, immunotherapy, and radiation.
In aspect, a device for treatment of solid cancers is disclosed. The device includes an external portable induction coil and a power source operatively connected to the external portable induction coil and configured to generate an induced electric field (iEF) in the external portable induction coil. The external portable induction coil is adapted to provide the iEF near or within a solid cancer.
In another aspect, a method for treatment of solid cancers is disclosed. The method includes generating an induced electric field (iEF) using a portable induction coil and providing the iEF near or within a solid cancer.
This summary is provided to introduce a selection of concepts in a simplified form that are further described below in the detailed description. This summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used to limit the scope of the claimed subject matter.
The foregoing summary, as well as the following detailed description of illustrative embodiments, is better understood when read in conjunction with the appended drawings. For the purpose of illustrating the disclosed embodiments, there is shown in the drawings example constructions of the embodiments; however, the possible embodiments are not limited to the specific methods and instrumentalities disclosed. In the drawings:
The following description of the disclosure is provided as an enabling teaching of the disclosure in its best, currently known embodiment(s). To this end, those skilled in the relevant art will recognize and appreciate that many changes can be made to the various embodiments of the invention described herein, while still obtaining the beneficial results of the present disclosure. It will also be apparent that some of the desired benefits of the present disclosure can be obtained by selecting some of the features of the present disclosure without utilizing other features. Accordingly, those who work in the art will recognize that many modifications and adaptations to the present disclosure are possible and can even be desirable in certain circumstances and are a part of the present disclosure. Thus, the following description is provided as illustrative of the principles of the present disclosure and not in limitation thereof.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood to one of ordinary skill in the art to which this invention belongs. As used in the specification and claims, the singular form “a,” “an,” and “the” include plural references unless the context clearly dictates otherwise. As used herein, the terms “can,” “may,” “optionally,” “can optionally,” and “may optionally” are used interchangeably and are meant to include cases in which the condition occurs as well as cases in which the condition does not occur. Reference in the specification to “one embodiment” or “an embodiment” or “an example embodiment” means that a particular feature, structure, or characteristic described is included in at least one embodiment described herein and does not imply that the feature, structure, or characteristic is present in all embodiments described herein. Publications cited herein are hereby specifically incorporated by reference in their entireties and at least for the material for which they are cited.
Ranges can be expressed herein as from “about” one particular value, and/or to “about” another particular value. When such a range is expressed, another embodiment includes from the one particular value and/or to the other particular value. Similarly, when values are expressed as approximations, by use of the antecedent “about,” it will be understood that the particular value forms another embodiment. It will be further understood that the endpoints of each of the ranges are significant both in relation to the other endpoint, and independently of the other endpoint. It is also understood that there are a number of values disclosed herein, and that each value is also herein disclosed as “about” that particular value in addition to the value itself. For example, if the value “10” is disclosed, then “about 10” is also disclosed.
Oxidative phosphorylation in the mitochondria of metastatic breast cancer cells (MDA-MB-231) is suppressed by iEFs but not in the normal MCF10A breast cells. This is evidenced by
This demonstrates that iEFs may be used to hinder metastasis, which is an energy-intensive process. Though cancer cells are known to rely on other metabolic pathways such as glycolysis, fatty acid metabolism, and glutamine metabolism, they still rely primarily on oxidative phosphorylation to generate energy required for metastasis. Therefore, as disclosed herein, iEFs can be effective in attacking the most energetic pathways that cancer cells use to metastasize to distant sites.
As mentioned above, induced electric fields play a role in selectively altering the metabolic pathways of breast cancer cells, hindering their capacity to migrate and replicate, thus rendering them less metastatic. In accordance with the present disclosure, this may be used to hinder tumor progression and metastasis. With reference to
The orthotopic mouse model recapitulates the various stages of metastatic breast cancer progression. In this model, highly metastatic mouse triple-negative breast cancer (TNBC) cells (Mvt1) are injected (5×105 cells in 100 μL PBS) orthotopically into the mammary fat pads of wild-type FVB background female mice (an albino inbred, laboratory, and immunocompetent (i.e., with intact immune system) mouse strain that is named because of its susceptibility to Friend leukemia Virus B) 6 weeks of age and metastasize into the lungs. The mice were placed in cages which themselves were placed within the housing 302 around which the Solenoid-like coil 304 is wrapped, as shown in
Tumor associated macrophages (TAMs) have been shown to be vital to the growth and dissemination of breast cancer primary tumors. Specifically, TAMs play a role in angiogenesis and intravasation of cancer cells leading to metastases. Cells from the primary tumors of the treated and untreated mice were analyzed for the presence of M2-type TAMs. Cells were tagged for CD45 and CD11b surface markers to identify CD45+/CD11b+ monocytes.
Breast cancers harbor a subset of cells with stem-like properties known as cancer stem-like cells or CSCs, with properties including self-renewal and drug resistance, that drive tumor initiation, recurrence, and metastasis. Breast CSCs are defined by markers aldehyde dehydrogenase (ALDH+) and CD24−/CD44+. These markers classify CSCs into more epithelial, proliferative cells (ALDH+); mesenchymal, invasive cells (CD24−/CD44+) that arise from epithelial-to-mesenchymal transition (EMT); and hybrid cells (ALDH+/CD24−CD44+) with plastic, intermediate phenotypes. The presence of cancer stem cells (CSCs) in the primary tumor has shown to have a strong correlation with metastases. While there is no causative link between CSCs and distant metastases, it is still an important prognostic tool. For example,
Lysates from the primary tumors were analyzed for expression of specific epithelial-mesenchymal transition (EMT) markers as well as phosphorylated EGFR. It can be seen from
In vitro and in vivo results to date thus indicate that iEF treatment can be used to control and hinder metastatic disease without any accompanying adverse effects. The translation of iEF treatment for higher animals and humans can potentially be enabled in several forms. As shown in
In vitro and in vivo results to date indicate that iEF treatment can inhibit functions of chemokines and growth factors such CXCR4/CXCL12 and EGF/EGFR as well enchase the anti-tumor immune responses. The iEF treatment could be used in combination with other therapies including chemo, targeted and immunotherapy to enhance the therapeutic effects of these therapies.
Additional experiments were conducted in an orthotopic mouse model (BALB/c wild-type immunocompetent mice) and applied iEF treatment (as described previously with the Mvt-1 mouse model) but with a more aggressive 4T1 cell line. The same iEF apparatus shown in
As shown in
As shown
Thus, the iEF treatment reduced breast tumor progression and metastasis. iEFs application also significantly reduced the infiltration of macrophages and MDSCs both in the primary tumor and its secondary site. Moreover, iEFs significantly reduced the infiltration of M2 TAMs in the TME. Furthermore, the present disclosure shows that iEFs augmented the recruitment of activated CD8+ T cells in the TME. Myeloid-derived suppressor cells (MDSCs) are a heterogeneous population of myeloid cells that support tumor growth and metastasis. MDSCs are known to promote tumor-associated immunosuppressive effects in the TME. MDSCs play a crucial role in diminishing the efficacy of immunotherapies and enhancing drug resistance. Therefore, iEF treatment could be used to inhibit the recruitment and polarization of immune-suppressive myeloid cells while increasing the infiltration of CD8+ T cells in the breast TME, to improve the overall anti-tumor immunity thereby reducing breast tumor growth and metastasis.
The treatment with iEF disclosed herein did not show any negative effects on mice. In-vitro and in-vivo results strongly suggest that inhibiting the growth and metastasis of breast cancer using iEF treatment is highly safe and effective.
Numerous characteristics and advantages provided by aspects of the present invention have been set forth in the foregoing description and are set forth in the attached Appendix A together with details of structure and function. While the present invention is disclosed in several forms, it will be apparent to those skilled in the art that many modifications can be made therein without departing from the spirit and scope of the present invention and its equivalents. Therefore, other modifications or embodiments as may be suggested by the teachings herein are particularly reserved.
Although the subject matter has been described in language specific to structural features and/or methodological acts, it is to be understood that the subject matter defined in the appended claims is not necessarily limited to the specific features or acts described above. Rather, the specific features and acts described above are disclosed as example forms of implementing the claims.
Filing Document | Filing Date | Country | Kind |
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PCT/US2022/044834 | 9/27/2022 | WO |
Number | Date | Country | |
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63248694 | Sep 2021 | US | |
63299668 | Jan 2022 | US |