Neoadjuvant calcium electroporation for potentially curable colorectal cancer. 2024

M Broholm, and R Vogelsang, and M Bulut, and M Gögenur, and T Stigaard, and A Orhan, and X Schefte, and A M K Fiehn, and J Gehl, and I Gögenur
Department of Surgery, Zealand University Hospital, Center for Surgical Science, Lykkebaekvej 1, 4600, Koege, Denmark. malenebroholm87@gmail.com.

BACKGROUND The development of new perioperative treatment modalities to activate the immune system in colorectal cancer might have a beneficial effect on reducing the risk of recurrence after surgery. Calcium electroporation is a promising treatment modality that potentially modulates the tumor microenvironment. The aim of this study was to evaluate the safety of the procedure in the neoadjuvant setting in localized left-sided colorectal cancer (CRC). METHODS The study included patients with potentially curable sigmoid or rectal cancer with no indication for other neoadjuvant treatment. Patients were offered calcium electroporation as a neoadjuvant treatment before elective surgery. Follow-up visits were conducted on the preoperative day before elective surgery, POD2, POD14, and POD30, with an evaluation of adverse events, impact on elective surgery, clinical examination, and quality of recovery. RESULTS Endoscopic calcium electroporation was performed as an outpatient procedure in all 21 cases, with no procedure-related complications reported. At follow-up, five adverse events were registered, two of which were classified as serious adverse events. Surgery was performed as planned in 19 patients (median time to surgery, 8 days), and the final two patients underwent surgery with a delay due to adverse events (14 and 33 days). No significant impact on the quality of recovery scores nor inflammatory markers were seen before and after calcium electroporation, nor baseline and POD30. CONCLUSIONS Endoscopic calcium electroporation is a safe and feasible procedure in patients with potentially curable CRC. The study showed limited side effects and limited impact on the following elective surgical resection.

UI MeSH Term Description Entries
D012004 Rectal Neoplasms Tumors or cancer of the RECTUM. Cancer of Rectum,Rectal Cancer,Rectal Tumors,Cancer of the Rectum,Neoplasms, Rectal,Rectum Cancer,Rectum Neoplasms,Cancer, Rectal,Cancer, Rectum,Neoplasm, Rectal,Neoplasm, Rectum,Rectal Cancers,Rectal Neoplasm,Rectal Tumor,Rectum Cancers,Rectum Neoplasm,Tumor, Rectal
D002118 Calcium A basic element found in nearly all tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. Coagulation Factor IV,Factor IV,Blood Coagulation Factor IV,Calcium-40,Calcium 40,Factor IV, Coagulation
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015179 Colorectal Neoplasms Tumors or cancer of the COLON or the RECTUM or both. Risk factors for colorectal cancer include chronic ULCERATIVE COLITIS; FAMILIAL POLYPOSIS COLI; exposure to ASBESTOS; and irradiation of the CERVIX UTERI. Colorectal Cancer,Colorectal Carcinoma,Colorectal Tumors,Neoplasms, Colorectal,Cancer, Colorectal,Cancers, Colorectal,Carcinoma, Colorectal,Carcinomas, Colorectal,Colorectal Cancers,Colorectal Carcinomas,Colorectal Neoplasm,Colorectal Tumor,Neoplasm, Colorectal,Tumor, Colorectal,Tumors, Colorectal
D059016 Tumor Microenvironment The milieu surrounding neoplasms consisting of cells, vessels, soluble factors, and molecules, that can influence and be influenced by, the neoplasm's growth. Cancer Microenvironment,Cancer Microenvironments,Microenvironment, Cancer,Microenvironment, Tumor,Microenvironments, Cancer,Microenvironments, Tumor,Tumor Microenvironments
D018274 Electroporation A technique in which electric pulses, in kilovolts per centimeter and of microsecond-to-millisecond duration, cause a loss of the semipermeability of CELL MEMBRANES, thus leading to ion leakage, escape of metabolites, and increased uptake by cells of drugs, molecular probes, and DNA. Depending on the dosage, the formation of openings in the cell membranes caused by the electric pulses may or may not be reversible. Electric Field-Mediated Cell Permeabilization,Irreversible Electroporation,Reversible Electroporation,Electropermeabilisation,Electric Field Mediated Cell Permeabilization,Electroporation, Irreversible,Electroporation, Reversible
D020360 Neoadjuvant Therapy Preliminary cancer therapy (chemotherapy, radiation therapy, hormone/endocrine therapy, IMMUNOTHERAPY, HYPERTHERMIA, INDUCED etc.) that is given before the main therapy. Neoadjuvant Chemoradiation,Neoadjuvant Chemoradiation Therapy,Neoadjuvant Chemoradiation Treatment,Neoadjuvant Chemoradiotherapy,Neoadjuvant Chemotherapy,Neoadjuvant Chemotherapy Treatment,Neoadjuvant Radiation,Neoadjuvant Radiation Therapy,Neoadjuvant Radiation Treatment,Neoadjuvant Radiotherapy,Neoadjuvant Systemic Therapy,Neoadjuvant Systemic Treatment,Neoadjuvant Treatment,Chemoradiation Therapy, Neoadjuvant,Chemoradiation Treatment, Neoadjuvant,Chemoradiation, Neoadjuvant,Chemoradiotherapy, Neoadjuvant,Chemotherapy Treatment, Neoadjuvant,Chemotherapy, Neoadjuvant,Neoadjuvant Chemoradiation Therapies,Neoadjuvant Chemoradiation Treatments,Neoadjuvant Chemoradiations,Neoadjuvant Chemoradiotherapies,Neoadjuvant Chemotherapies,Neoadjuvant Chemotherapy Treatments,Neoadjuvant Radiation Therapies,Neoadjuvant Radiation Treatments,Neoadjuvant Radiations,Neoadjuvant Radiotherapies,Neoadjuvant Systemic Therapies,Neoadjuvant Systemic Treatments,Neoadjuvant Therapies,Neoadjuvant Treatments,Radiation Therapy, Neoadjuvant,Radiation Treatment, Neoadjuvant,Radiation, Neoadjuvant,Radiotherapy, Neoadjuvant,Systemic Therapy, Neoadjuvant,Systemic Treatment, Neoadjuvant,Therapy, Neoadjuvant,Therapy, Neoadjuvant Chemoradiation,Therapy, Neoadjuvant Radiation,Therapy, Neoadjuvant Systemic,Treatment, Neoadjuvant,Treatment, Neoadjuvant Chemoradiation,Treatment, Neoadjuvant Chemotherapy,Treatment, Neoadjuvant Radiation,Treatment, Neoadjuvant Systemic

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