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Thermal Therapy

What is Thermal Therapy?

Thermal therapy is a treatment modality for cancer patients which increases the patient’s body temperature in order to boost the immune system, inhibit tumor growth and increase the sensitivity of other anti-cancer treatments.

Thermal therapy is toxic for cells in a hypoxic and low pH environment, conditions which are found specifically within tumor tissue, due to insufficient blood perfusion 1.

Consequently, an anti-cancer effect can be obtained within the fever range with minimal injury to normal cells 1,2.

Leveraging these effects, thermal therapy increases the patient’s body temperature by applying heat externally in a controlled and precise manner.

Thermal therapy

Thermal Therapy supports other cancer therapies in different ways:

By activating the immune cells.
Heat has the potential to boost a person’s immune system to help fight cancer. Recent research has identified complex effects of temperature on immune cells which may enhance immune surveillance 3-7.

By shrinking tumors.
High temperatures have a direct cytotoxic effect by inducing necrosis and apoptosis8,9.

By enhancing the efficacy of chemotherapy.
Heat increases permeabilization and the blood flow in the stroma of the tumor, enhancing the oxidative stress (damage) of cancer cells10 and the resorption of anti-cancer drugs into cancer cells2,11,12. Chemotherapy therefore, becomes more effective without further toxic effects to the patient2,13,14. This has been demonstrated in several recent phase III clinical trials with cancer patients15-18.

By damaging radio-resistant cancer cells.
Heat inhibits the recovery of cancer cells from DNA damage and can act on cancer cells resistant to radiation 19. Hence, radiotherapy and thermal therapy are complementary in their action: free radicals are formed by radiotherapy, which damage the DNA of the tumor cells, then thermal therapy inhibits the repair of the damaged DNA 19,20.

By enhancing radiotherapy efficacy.
Clinical trials combining thermal and radiation therapy showed that thermal therapy makes radiotherapy more efficient, increasing the sensitivity of cancer cells to radiation19,21,22 by 1.5–5 times 23. This allows the radiation dose to be reduced, easing its side-effects on patients without reducing its therapeutic effects24-27.

By decreasing pain and improving quality of life.
Thermal therapy may also significantly reduce pain during treatments, which may improve the quality of the patient’s life. This effect has been observed in clinical trials of patients with metastases25,28.

Supporting pancreatic cancer treatment

The additional effect of thermal therapy to standard treatment (such as chemotherapy and radiotherapy) has been shown in patients diagnosed with pancreatic cancer.

These curves show the percentage of people who did not have new tumor growth or cancer spread during or after treatment (progression-free survival) with CRHT (chemoradiotherapy-hyperthermia) in comparison to that of patients who underwent chemoradiotherapy (CRT) alone.

Adding thermal therapy to the treatment regime of chemoradiotherapy increased the progression-free survival of patients from 4.9 to 8.8 months. Their overall survival increased from 9.6 to 18.6 months (Ohguri et al, 2008, Tobata Hospital, Japan).

Overall, 14 clinical trials included 395 patients with locally advanced and/or metastatic pancreatic cancer, of whom 248 received thermal therapy. The response rate reported in three trials with a control group, was better for the hyperthermia groups compared to the control group (chemotherapy and/or radiotherapy)(43.9% vs. 35.3%) (van der Horst et al, 2017, Amsterdam, Nederland).

Preclinical studies

ElmediX has developed a highly accurate and sensitive systemic thermal therapy for therapeutic intervention.

The device is designed to be safe and efficient as an anti-cancer treatment.

Promising preclinical data demonstrates the safety and efficacy of this method in CAM (chicken embryo) and animal models, therefore a first-in-human clinical trial has been initiated.

1) Minipigs

2) DOGS

Healthy minipigs have been used to prove the technical feasibility and safety of thermal therapy.

The minipig is one of the most frequently used large animal models in biomedical research due to its anatomical and physiological similarity to humans.

Evaluation of the treated animals revealed some changes in biochemical blood parameters, but none of them were considered clinically significant.

The animals remained healthy throughout the whole procedure and the follow-up period.

After having proven the safety in healthy minipigs, the treatment was tested in a population of elderly dogs with advanced or metastatic cancer.

Dogs form an ideal model for cancer in humans because of histological, genetical and environmental similarities.

Dogs with advanced and/or metastatic cancer were treated with thermal therapy in combination with a reduced standard of care treatment.

The evolution of their clinical parameters indicated the safety of the treatment and the improvement of their quality of life.