Immunotherapeutic methods using irreversible electroporation
Methods for treating tissue with irreversible electroporation and immunotherapy are described. The methods include placing a probe in tissue within a human body, wherein the probe has at least a first electrode, applying a plurality of electrical pulses through the first electrode and a second electrode, causing irreversible electroporation (IRE) of the tissue within a target ablation zone, and administering one or more exogenous agents into the tissue within the target ablation zone or to the human, thereby stimulating or otherwise modulating an immune system response within the body.
1. A method for treating tissue comprising:
placing a probe in tissue within a human body, wherein the probe has at least a first electrode;
applying a plurality of electrical pulses through the first electrode and a second electrode, wherein the electrical pulses have a pulse length of 10 microseconds or less and there is a delay between two adjacent pulses;
causing irreversible electroporation (IRE) of the tissue within a target ablation zone; and
administering one or more exogenous or endogenous agents into the tissue within the target ablation zone;
thereby stimulating or otherwise modulating an immune system response within the body.
2. The method of claim 1 , wherein the one or more exogenous or endogenous agents comprises a radioisotope, a natural protein, a synthetic protein, a natural peptide, synthetic peptide, a peptidomimetic, an antibody, an antibody fragment, an antibody conjugate, a nucleic acid, an siRNA, antisense RNA, an aptamer, a ribozyme, or oligonucleotide, a viral vector comprising a nucleic acid, a bioactive agent, a cancer therapeutic agent, an engineered cell, or any combination thereof.
3. The method of claim 2 , wherein the cancer therapeutic agent is chosen from a chemotherapy agent, a targeted cancer therapy agent, a differentiating therapy agent, a hormone therapy agent, or an immunotherapy agent.
4. The method of claim 3 , wherein the immunotherapy agent is chosen from monoclonal antibody therapies, non-specific immunotherapies and adjuvants, immunomodulating drugs, and cancer vaccines.
5. The method of claim 1 , wherein the one or more exogenous or endogenous agents are injected through at least one dispersion outlet on the probe.
6. The method of claim 1 , wherein the electrical pulses have parameters further comprising:
a pulse train of 0.1 microsecond to 1 second;
an alternating polarity;
an amplitude of 2500 V/cm to 10,000 V/cm; and/or
the delay between electrical pulses is on the order of microseconds or seconds.
7. The method of claim 1 , wherein the electrical pulses have parameters further comprising monophasic pulses or biphasic pulses.
8. The method of claim 1 , further comprising applying the electrical pulses as a pulse train comprising bursts of pulses with the delay being between electrical pulses and/or between bursts.
9. The method of claim 1 , wherein the one or more exogenous or endogenous agents are administered into the body by parenteral, intravenous, intraarterial, intradermal, transdermal, intranasal, local or intralesional, intraperitoneal, intramuscular, buccal, oral, or transmucosal administration.
10. The method of claim 1 , wherein one or more of the exogenous or endogenous agents are chosen from:
small interfering RNAs (siRNAs), engineered cells, nanoparticle formulations, single or multi-walled carbon nanotubes (CNTs), cancer vaccines, and viral vectors.
11. A method for treating tissue within a human comprising:
placing a probe in tissue within a human, wherein the probe has at least a first electrode;
applying a plurality of electrical pulses through the first electrode and a second electrode;
causing irreversible electroporation (IRE) of the tissue within a target ablation zone in an amount sufficient to promote an immune response; and
administering one or more exogenous or endogenous agents to the human to further stimulate the immune system.
12. The method of claim 11 , wherein the one or more exogenous or endogenous agents are administered to the human subject by parenteral, intravenous, intraarterial, intradermal, transdermal, intranasal, local or intralesional, intraperitoneal, intramuscular, buccal, oral, or transmucosal administration.
13. The method of claim 11 , wherein the one or more exogenous or endogenous agents are introduced into tissue surrounding the target ablation zone by way of systemic administration.
14. The method of claim 13 , wherein the target ablation zone comprises tumor tissue and the tissue surrounding the target ablation zone comprises a tumor margin.
15. The method of claim 14 , wherein the tumor margin comprises tumor cells, and the one or more exogenous or endogenous agents kill the tumor cells.
16. The method of claim 11 , wherein the one or more exogenous or endogenous agents is administered 5 minutes, 15 minutes, 0.5 hr, 1 hr, 2 hr, 4 hr, 8 hr, or 12 hr before the applying of the plurality of electrical pulses.
17. The method of claim 11 , wherein the plurality of electrical pulses are administered at a time when the one or more exogenous agents achieves C max in blood, or within 10, 20, 30, 45, or 60 minutes of such time.
18. The method of claim 11 , wherein the one or more exogenous or endogenous agents are injected through at least one dispersion outlet on the probe.
19. The method of claim 11 , wherein the electrical pulses have parameters further comprising: a pulse length or pulse train of 0.1 microsecond to 1 second; and an amplitude of 2500 V/cm to 10,000 V/cm.
20. The method of claim 19 , wherein there is a delay between electrical pulses on the order of microseconds or seconds.
21. The method of claim 19 , wherein the electrical pulses have parameters further comprising monophasic pulses or biphasic pulses with or without a delay between pulses.
22. The method of claim 11 , wherein the electrical pulses have parameters further comprising:
a pulse length or pulse train of 0.1 microsecond to 1 second; and
an amplitude of 500 V/cm to 10,000 V/cm.
23. The method of claim 22 , wherein there is a delay between electrical pulses on the order of microseconds or seconds.
24. The method of claim 11 , further comprising applying the electrical pulses as a pulse train comprising bursts of pulses with a delay between electrical pulses and/or between bursts.
25. The method of claim 11 , wherein the one or more exogenous or endogenous agents comprises a radioisotope, a natural protein, a synthetic protein, a natural peptide, synthetic peptide, a peptidomimetic, an antibody, an antibody fragment, an antibody conjugate, a nucleic acid, an siRNA, antisense RNA, an aptamer, a ribozyme, or oligonucleotide, a viral vector comprising a nucleic acid, a bioactive agent, a cancer therapeutic agent, an engineered cell, or any combination thereof.
26. The method of claim 25 , wherein the cancer therapeutic agent is chosen from a chemotherapy agent, a targeted cancer therapy agent, a differentiating therapy agent, a hormone therapy agent, or an immunotherapy agent.
27. The method of claim 26 , wherein the immunotherapy agent is chosen from monoclonal antibody therapies, non-specific immunotherapies and adjuvants, immunomodulating drugs, and cancer vaccines.
28. The method of claim 11 , wherein the probe is biopolar and comprises a heat sink.
29. A method for treating tissue comprising:
placing a probe in tissue within a human body, wherein the probe has at least a first electrode;
applying a plurality of electrical pulses through the first electrode and a second electrode, wherein the electrical pulses have a pulse length of 10 microseconds or less and there is a delay between two adjacent pulses; and
causing irreversible electroporation (IRE) of the tissue within a target ablation zone in an amount sufficient to promote an immune response by way of immune cells that respond to tissue injury resulting from the IRE.
30. The method of claim 29 , wherein the IRE is in an amount sufficient to promote the immune response by way of a tumor specific immune response capable destroying residual micro-metastases.