Breast Cancer
Conditions
Keywords
cryotherapy, cytotoxicity
Brief summary
Cryotherapy is a cold ablation technique used in many tumor locations. The destruction of tissues by cryoablation preserves proteins and in particular anti-tumor antigens, which could induce the stimulation of an immune response. Compared to other interventional radiology techniques, cryotherapy induces a higher immunogenic response. Studies describe complex responses with elevated levels of activating NK cells, circulating and anti-tumor T cells, and pro-inflammatory and NF-KB dependent cytokines. In breast cancer, whether or not an immune response is triggered depends on the type of cryoablation used. Indeed, high intensity cryoablation (rapid freezing in one cycle of the entire tumor volume) seems to induce a tumor-specific immunodestructive response, whereas low frequency cryoablation (several small repetitive cycles until a sufficient volume of ice is obtained) does not induce an immunogenic response and can even induce an immunoregulation with immunotolerance of the tumor cells The University Hospital of Nîmes has recently acquired a new liquid nitrogen cryotherapy technique, more powerful than the one classically performed with Argon. This technique is used for palliative and analgesic purposes in patients with metastatic breast cancer presenting painful subcutaneous metastases. The aim of this study is to evaluate in these patients the changes in the tumor microenvironment and the immune response potentially induced by this very high intensity cryotherapy. The study investigators hypothesize that locoregional treatment with liquid nitrogen cryotherapy of subcutaneous breast cancer metastases will allow a systemic response through the induction of an immune response. A better understanding of the type of immune response induced will allow the development of combined therapeutic strategies with curative and not only palliative and analgesic aims.
Interventions
PROCEDURECryotherapy treatment
Cryotherapy treatment administered by an interventional radiologist: the cryotherapy needle is placed under local anesthesia, ultrasound monitoring in real time. A complete cryotherapy cycle is performed with: freezing until the entire tumor is frozen as judged by ultrasound, then thawing for the same duration and refreezing according to the same principle.
Sponsors
Centre Hospitalier Universitaire de Nīmes
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 95 Years
Healthy volunteers
No
Inclusion criteria
* The patient must have given their free and informed consent * The patient must be a member or beneficiary of a health insurance plan * Patient with metastatic breast cancer with painful subcutaneous metastases. * Patient eligible for cryotherapy. * Therapeutic decision of antalgic and palliative treatment by cryotherapy taken in Pluridisciplinary Consultation Meeting. * Patient available for 15-day follow-up.
Exclusion criteria
* The subject is in a period of exclusion determined by a previous study * The subject us unable to express their consent or refuses to sign the consent form * The patient is under safeguard of justice or state guardianship
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Description of the immunological makeup of the tumor before liquid nitrogen cryotherapy treatment | Day 0 | Cytometry by Time Of Flight (CyTOF®) mass cytometry analysis of biopsy samples to identify lymphocyte and macrophage populations and anti-tumor markers |
| Description of the immunological makeup of the tumor after liquid nitrogen cryotherapy treatment | Day 15 | Cytometry by Time Of Flight (CyTOF®) mass cytometry analysis of biopsy samples to identify lymphocyte and macrophage populations and anti-tumor markers |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Level of pain related to subcutaneous metastases after cryotherapy treatment | Day 0 immediately after cryotherapy treatment | 0-10 Visual analog scale. Higher scores mean worse outcome. |
| Pain related to subcutaneous metastases before cryotherapy treatment | Day 0 immediately before cryotherapy treatment | Brief Pain Inventory (BPI): score from 0-120. Higher scores mean worse outcome. |
| Patients' tolerance to cryotherapy treatment | Day 15 | Collection of complications and adverse events according to Common Terminology Criteria for Adverse Events (CTCAE) criteria |
| Patient reported quality of before cryotherapy treatment | Day 0 | European Organisation for Research and Treatment of Cancer - C30 (EORTC QLQ-C30). This questionnaire is composed of 30 items grouped into 15 scales. A good quality of life is associated with a high score for the functional scales and a low score for the symptom scales |
| Patient reported quality of after cryotherapy treatment | Day 15 | European Organisation for Research and Treatment of Cancer - C30 (EORTC QLQ-C30). This questionnaire is composed of 30 items grouped into 15 scales. A good quality of life is associated with a high score for the functional scales and a low score for the symptom scales |
| Pain related to subcutaneous metastases after cryotherapy treatment | Day 0 immediately after cryotherapy treatment | Brief Pain Inventory (BPI): score from 0-120. Higher scores mean worse outcome. |
| Level of pain related to subcutaneous metastases before cryotherapy treatment | Day 0 immediately before cryotherapy treatment | 0-10 Visual analog scale. Higher scores mean worse outcome. |
Countries
France
Outcome results
None listed