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The Interrelationship Between Cryoablation, the Immune Response and the Tumor Microenvironment: Stimulatory and Suppressive Effects

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Tumor Ablation

Part of the book series: The Tumor Microenvironment ((TTME,volume 5))

Abstract

Cryoablation involves the use of freezing temperatures to kill cells and destroy tissue. Its history as a cancer therapy dates back over 100 years, however recent advances in technology have greatly expanded its clinical potential. Much of the interest in cryoablation centers on early observations that after freezing a primary lesion, distant, un-treated sites of disease began to regress. It was believed that this was secondary to cryoablation stimulating an anti-tumor immune response. This prompted multiple pre-clinical studies examining the impact of cryoablation on the immune response and the mechanisms involved. While most of these studies validated the ability of cryoablation to stimulate tumor recognition by the immune system, some studies demonstrated the opposite; tumor-bearing animals treated by cryoablation had diminished responses and increased tumor growth compared to controls. As our knowledge of the components of the immune system and their interactions in the generation, or suppression, of an immune response has increased, as well as our understanding of the mechanisms by which freezing leads to cell death, the immunomodulation seen with cryoablation is becoming clearer. Many questions still remain, but given the tremendous clinical potential in having a local therapy that could also have systemic benefits, further research in this area is strongly warranted. This chapter will review the history of cryosurgery for the treatment of cancer, including the observations of distant tumor regression; detail the mechanisms by which cryoablation leads to cancer cell death, and how this can be altered by variations in cryosurgical technique; and describe the pre-clinical data examining the relationship between cryoablation-induced cell death and both stimulatory and suppressive immune responses.

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Authors and Affiliations

  1. University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA

    Michael S. Sabel MD FACS

  2. Division of Surgical Oncology, 3304 Cancer Center, 1500 East Medical Center Drive, 48109-0932, Ann Arbor, MI, USA

    Michael S. Sabel MD FACS

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  1. Michael S. Sabel MD FACS
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Correspondence to Michael S. Sabel MD FACS .

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  1. and Immunology, Tel Aviv University, Department of Clinical Microbiology, Tel Aviv, 69978, Israel

    Yona Keisari

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Sabel, M. (2013). The Interrelationship Between Cryoablation, the Immune Response and the Tumor Microenvironment: Stimulatory and Suppressive Effects. In: Keisari, Y. (eds) Tumor Ablation. The Tumor Microenvironment, vol 5. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-4694-7_5

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