ECCT: Physical Therapy for Cancer -clinical report
総説
ECCT: Physical Therapy for Cancer -clinical report
Shinichiro Akiyama, Manato Akiyama, Warsito Purwo Taruno, Edi Sukur, Ahmad Novian Rahman Hakim, Wamid Antaboga
WAARM Journal, 2024; 6: 20–33
Key words: ECCT, Electrical Field, cancer treatment, glioblastoma multiforme, microtubule
Introduction
Cancer is the comprehensive term utilized to demonstrate a heterogenous group of various disorders characterized by rapid, uncontrolled growth of abnormal cells that can affect any part of the body. Cancer can change its genetic profile and go to other organs if not detected at an early stage, making it a difficult disease to conquer, resulting in still leading cause of death globally (1). The World Health Organization’s International Agency for Research (WHO IARC) https://gco.iarc.fr/today/online-analysis-pie estimated 19.3 million cancer diagnosis with more than 50% mortality in 2020. And 49.2% of cancer death was occurred in Asia. Despite continuous efforts in cancer treatment strategies, cancers including lung, colorectal, prostate and stomach cancers still demonstrate deplorable five-year survival rate (2) especially with the global COVID-19 pandemic retarding diagnosis and obscuring to receive cancer treatment (3, 4). Recent progress in understanding the molecular based cancer biology have allowed swift action and approval of breakthrough drug including highly selective pharmacologic product as well as aim driving fundamental characteristic of cancer. Now that we’re in an age of uncommon scientific advance against cancer. Notwithstanding this positive momentum, number of cancer related death has been steadily rising. Up-to-date developments in cancer research, especially in immunotherapy and targeted therapy, have initiated a reform. Electrical Field (EF) is the fourth modality in cancer therapy and is one of the most competitive emerging sphere in global biotechnology. Brain health, a Chinese company developing tumor treating fields, has made headlines when it raised about 100 million US dollar in 2021. We’ve been incorporating Electro Capacitive Cancer Therapy (ECCT) in Japan and overseas, which have a cooperative relationship centering on ECCT with conventional therapy, so that synergistic effects can be expected. Basic principle of EF is to collapse cell division by interrupting mitosis. There are two types of attractive machines until now. One is tumor-treating Fields (TTFields), the other is ECCT. TTFields are low intensity, medium-frequency, alternating EF through noninvasive transducer arrays setting up around the tumor. Because TTFields have found survival benefit in glioblastoma multiforme (GBM) patients, it led to its approval by FDA for recurrent and afresh diagnosed GBM after surgery and radiotherapy with adjuvant temozolomide (5-9). ECCT, which employs exposure to alternating current (AC) electric fields, is an emerging alternative approach to cancer therapy. Preliminary study shows that treatment involving low-voltage (18Vpp) medium-frequency (100 kHz) electric field exposure in vitro can inhibit MCF-7 growth by 28-39% and cause carcinoma cell shrinkage in mice after 2 weeks of EF exposure (10). ECCT can also have an anti-proliferative effect on breast tumor, in terms of the down-regulation of IL-18 and CCL-2 whose roles in the development of breast tumor (11). Omat RH, et al proved that non-contact EF exposure induces apoptosis of osteosarcoma cell line (MG-63 Cell Lines) through p53-independent p21 pathway (12). Until now, in vivo studies on effects of alternating EFs condition, have been studied diligently (11,13-17). These studies demonstrated that anticancer effects were achieved at specific modulation frequencies, that is cancer cell type, and clarified proliferative inhibition and mitotic spindle disruption following exposure to alternating electric fields (14,18,19). Delving a novel therapy that specifically recognize and kills cancer cells without affecting normal cells, has been a recent objective in theranostics (18).