JP2016538961A - 高周波電気的膜破壊(rf‐emb)による癌免疫療法 - Google Patents
高周波電気的膜破壊(rf‐emb)による癌免疫療法 Download PDFInfo
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Abstract
Description
本特許出願は、2013年12月5日に出願された、米国仮特許出願第61/912,172号明細書、発明の名称「免疫療法のための補助メカニズムとしての高周波電気的膜破壊(RF‐EMB)による抗原提示細胞に対する癌抗原強化提示」に対する優先権を主張し、参照によってその全体において本明細書中に援用される。本特許出願は、また、2014年8月4日に出願された、米国特許出願第14/451,333号明細書、発明の名称「組織切除のための高周波エネルギー電気的膜破壊のためのシステム及び方法」に対する優先権を主張し、参照によってその全体において本明細書中に援用される。
1467092722620_0
からダウンロード可能な、Foltz, G.による Algae Lysis With Pulsed Electric Fields,カリフォルニア州立工科大学、サンルイスオビスポ 2012の、藻類の膜破壊のために使用されるエネルギーパラメータを記載する研究から参照した。Foltzは、瞬時の電荷反転パルスを利用することなく、単極性パルスを用いて、このエネルギー必要量を示し、これを、EMBを生成するためのエネルギー必要量に対するワーストケースシナリオにした。
Claims (46)
- 生体内の望ましくない軟部組織を切除するための方法であって、
前記生体内部の前記軟部組織の位置を同定する工程と、
前記軟部組織に対する少なくとも一つの電極の位置を決定する工程と、
前記生体内部の前記位置に、前記少なくとも一つの電極を導入する工程と、前記少なくとも一つの電極は、該電極への電気パルスの送達を制御するためのコントローラに電気的に接続され、前記コントローラは、電気パルス発生器を備え、
前記軟部組織の複数の細胞の細胞膜の電気的膜破壊を生じさせるのに十分な電界を、前記軟部組織に印加して、細胞外空間内への全ての細胞内要素の即座の流出及び前記細胞外空間内への前記細胞膜の内部構成部分の露出を生じさせる工程と、を備え、前記電界は、前記パルス発生器から前記少なくとも一つの電極に、前記電気的膜破壊を生じるように構成された少なくとも一つの両極性電気パルスを送達することによって、前記軟部組織に印加される、生体内の望ましくない軟部組織を切除するための方法。 - 前記少なくとも一つの両極性電気パルスの電圧は、0.5kV〜10kVであり、前記電界の周波数は、14.2kHz〜500kHz未満である、請求項1に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記電界の前記周波数は、100Hz〜450kHzである、請求項2に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記両極性電気パルスの経時的な前記電圧は、極性振動の正極性及び負極性要素に対して、方形波形状の足跡を辿る、請求項2に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記両極性電気パルスの前記電圧は、各サイクルの正電荷と負電荷との間の、瞬時の電荷反転によって特徴付けられる、請求項2に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記少なくとも一つの両極性電気パルスの持続期間は、100〜1000マイクロ秒である、請求項1に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記決定する工程は、前記軟部組織の比誘電率及び導電性を評価又は測定する工程を、さらに備える、請求項1に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記少なくとも一つの両極性電気パルスは、一連の少なくとも100の両極性パルスであり、前記一連の前記各両極性パルスは、電圧が、前記少なくとも一つの電極に印加されない中間パルスバースト間隔によって分離されている、請求項1に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記軟部組織に、臨床的に重要な熱的損傷を引き起こさない電界を印加するために、前記パルス発生器から前記少なくとも一つの電極に送達される前記一連の電気パルスを構成する工程を、さらに備える、請求項8に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記一連の電気パルスは、前記軟部組織の温度を、高くて摂氏50℃まで上昇させる電界を印加するように構成される、請求項9に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記パルス発生器から前記少なくとも一つの電極に、前記軟部組織に第二の電界を印加するために送達される第二連の電気パルスを送達する工程を、さらに備える、請求項8に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記軟部組織に、臨床的に重要な熱的損傷を引き起こすために、前記第二の電界を印加するための前記第二連の電気パルスを構成する工程を、さらに備える、請求項11に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記組織の少なくとも部分の温度を、摂氏50℃を越えるように構成された第二連の電気パルスを、前記パルス発生器から前記少なくとも一つの電極に送達する工程を、さらに備える、請求項8に記載の生体内の望ましくない軟部組織を切除するための方法。
- 組織変化、細胞膜破壊及び細胞死は、前記軟部組織に、前記電界を印加した直後に採取された前記望ましくない軟部組織の試料中に、視覚的に観察可能であり、前記一連の電気パルスを送達することによって、前記軟部組織に、前記電界を印加した後、前記切除の有効性を決定するために、前記軟部組織の部分を直ちに生検する工程と、
前記有効性が、所定の閾値を超える場合、望ましくない軟部組織の前記切除を中止する工程と、
前記有効性が、前記所定の閾値を超えない場合、前記軟部組織に、第二の電界を印加するために、前記パルス発生器から前記少なくとも一つの電極に、第二の少なくとも一つの両極性電気パルスを送達する工程を、さらに備える、請求項8に記載の生体内の望ましくない軟部組織を切除するための方法。 - 前記第二の少なくとも一つの両極性電気パルスは、前記第二の電界が、前記軟部組織の複数の細胞の前記細胞膜の電気的膜破壊を生じさせるのに十分であるように構成された第二連の少なくとも100の電気パルスである、請求項14に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記第二の少なくとも一つの両極性電気パルスは、前記第二の電界が、前記組織の少なくとも部分の温度を、摂氏50℃を超えさせるように構成される、請求項14に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記第二の電界は、、前記組織の少なくとも部分の温度が、摂氏60℃を超えさせるが、摂氏95℃を超えさせない、請求項14に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記少なくとも一つの電極に近接して温度プローブを導入する工程と、前記温度プローブは、前記コントローラに動作可能に接続され、前記コントローラに温度読み取りを報告する工程と、を、さらに備え、前記コントローラは、前記報告された温度に応じて、前記少なくとも一つの両極性電気パルスの少なくとも一つの特性を変更することを制御する、請求項1に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記温度プローブは、熱電対である、請求項18に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記温度プローブは、前記少なくとも一つの電極に一体化されるとともに、それとともに導入される、請求項18に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記少なくとも一つの両極性電気パルスは、電圧が、前記少なくとも一つの電極に印加されない中間パルスバースト間隔によって分離された一連の少なくとも100の両極性パルスであり、
前記コントローラのメモリ内に、少なくとも一つの温度設定点を格納する工程と、
前記一連の少なくとも一つのパルス持続期間の少なくとも部分に対して、前記コントローラによって、前記温度設定点を越える、前記温度プローブから前記コントローラに報告された前記温度読み取りに応じて、前記一連の前記中間パルスバースト間隔及びパルスの総数を変更する工程と、
を、さらに備える、請求項18に記載の生体内の望ましくない軟部組織を切除するための方法。 - 前記温度設定点を下回る、前記温度プローブによって報告された前記温度に応じて、前記変更する工程を開始する工程を、さらに備える、請求項21に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記変更する工程は、前記パルス持続期間を減少させる工程を備える、請求項21に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記変更する工程は、前記中間パルスバースト間隔を増加させる工程を備える、請求項22に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記変更する工程は、前記一連におけるパルスの数を減少させる工程を備える、請求項23に記載の生体内の望ましくない軟部組織を切除するための方法。
- コントローラのメモリ内に、少なくとも一つの最大電流設定点を格納する工程と、前記コントローラは、少なくとも一つの両極性電気パルスの前記送達を制御し、
前記コントローラによって、前記少なくとも一つの電極を通る電流を決定する工程と、
前記電流が前記最大電流設定点に等しい場合、前記少なくとも一つの電極に送達される前記少なくとも一つの両極性電気パルスの前記電圧を減少させる工程と、
を、さらに備える、請求項1に記載の生体内の望ましくない軟部組織を切除するための方法。 - 前記細胞内要素及び前記細胞膜の内部構成部分は、前記生体の前記細胞外空間内に残され、前記生体の免疫学的プロセスは、前記細胞外空間から前記細胞内要素及び前記細胞膜の内部構成部分を除去するために、活性化される、請求項1に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記細胞内要素は、細胞抗原を備え、前記細胞膜の前記内部構成部分は、細胞膜特異抗原を、さらに備え、
前記免疫学的プロセスは、一以上の前記細胞抗原及び前記細胞膜特異抗原を有する前記生体における第二の部位での望ましくない軟部組織であって、望ましくない軟部組織を切除する前記方法を経験しなかった前記生体における第二の部位での前記望ましくない軟部組織を除去する工程を、さらに備える、請求項27に記載の生体内の望ましくない軟部組織を切除するための方法。 - 前記細胞内要素は、細胞抗原を備え、前記細胞膜の前記内部構成部分は、前記細胞膜に特異的な抗原を、さらに備え、
前記生体の前記免疫学的プロセスが、前記細胞外空間から前記細胞内要素及び前記細胞膜の内部構成部分を除去するために、活性化されることを増加させるために、免疫学的応答促進剤を、前記生体に投与する工程を、さらに備える、請求項27に記載の生体内の望ましくない軟部組織を切除するための方法。 - 前記免疫学的応答促進剤は、細胞傷害性リンパ球のCTLA‐4抑制シグナルの抑制をブロックする、請求項29に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記免疫学的応答促進剤は、静脈内、経口及び筋肉内の一つによって投与される、請求項29に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記免疫学的応答促進剤は、前記軟部組織に、電界を印加する前記工程の前又は後に、望ましくない軟部組織内に直接又は望ましくない軟部組織に隣接して注入される、請求項29に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記免疫学的応答促進剤は、自己樹状細胞を含む、請求項29に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記免疫学的応答促進剤は、S100A9に結合し、骨髄性細胞機能を改変する、請求項29に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記免疫学的応答促進剤は、静脈内、経口及び筋肉内の一つによって投与される、請求項29に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記免疫学的応答促進剤は、前記軟部組織に、電界を印加する前記工程の前又は後に、望ましくない軟部組織内に直接又は望ましくない軟部組織に隣接して注入される、請求項29に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記免疫学的応答促進剤は、自己樹状細胞を含む、請求項36に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記生体内部の前記軟部組織内に、一以上のセンサを挿入する工程と、
複数の細胞の細胞膜の電気的膜破壊を生じさせるのに十分な電界を、前記軟部組織に印加する前記工程と同時に、前記センサから複数の測定値を得る工程と、
前記測定値に基づいて、生体内の望ましくない軟部組織を切除する前記方法の処置有効性を決定する工程と、
を、さらに備える、請求項1に記載の生体内の望ましくない軟部組織を切除するための方法。 - 少なくとも一つの前記一以上のセンサは、pHセンサ、乳酸センサ、グルコースセンサ、電気インピーダンスセンサ、カリウムセンサ、尿酸センサ、及び分光計を含む群から選択される、請求項38に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記処置有効性に基づいて、前記電界の一以上のパラメータを変更する工程を、さらに備える、請求項38に記載の生体内の望ましくない軟部組織を切除するための方法。
- 生体内の望ましくない軟部組織を切除するための方法であって、
前記生体内部の前記軟部組織の位置を同定する工程と、
前記軟部組織の組織型に基づいて、電気的膜破壊によって細胞膜破裂を生じさせるために、前記軟部組織の細胞に印加されるのに必要な最小エネルギープロファイルを決定する工程と、
細胞塊に対する少なくとも一つの電極の位置を決定する工程と、
前記生体内部の前記位置に前記少なくとも一つの電極を導入する工程と、前記少なくとも一つの電極は、該電極への電気パルスの送達を制御するためのコントローラに電気的に接続され、前記コントローラは、電気パルス発生器を備え、
前記最小エネルギープロファイル及び前記少なくとも一つの電極の前記位置に基づいて、前記細胞塊に、前記最小エネルギープロファイルを印加するのに必要な電界強度を決定する工程と、
前記電界強度に基づいて、少なくとも100のパルスを有する両極性電気パルス列プロファイルを決定する工程と、前記両極性電気パルス列プロファイルは、パルス数、パルス持続期間及び中間パルスバースト間隔によって特徴付けられ、前記パルスは、それぞれ、周波数及び電圧を有し、前記電圧は、極性の瞬時の反転によって特徴付けられ、
前記コントローラによって、前記パルス発生器から前記少なくとも一つ電極に、前記両極性電気パルス列プロファイルに従う一連の電気パルスを送達し、それによって、パルス電界が発生され、前記パルス電界は、電気的膜破壊によって、細胞死を引き起こすために、前記軟部組織の複数の前記細胞に、十分なエネルギーを印加する、生体内の望ましくない軟部組織を切除するための方法。 - 前記免疫学的応答促進剤は、PD‐1及びPD‐L1を含む群から選択されるタンパク質をブロックする、請求項29に記載の生体内の望ましくない軟部組織を切除するための方法。
- 生体内の免疫学的応答を増加させるための方法であって、
前記生体内部の望ましくない軟部組織の位置を同定する工程と、
前記望ましくない軟部組織上で、非熱アブレーション処置を実行する工程と、
前記生体に、免疫学的応答促進剤を投与する工程と、
を備える、生体内の免疫学的応答を増加させるための方法。 - 非熱アブレーション処置を実行する前記工程は、前記望ましくない軟部組織に対する少なくとも一つの電極の位置を決定する工程と、
前記生体内部の前記位置に、前記少なくとも一つの電極を導入する工程と、
前記少なくとも一つの電極は、該電極への電気パルスの送達を制御するためのコントローラに電気的に接続され、前記コントローラは、電気パルス発生器を備え、
前記軟部組織の複数の細胞の細胞膜の電気的膜破壊を生じさせるのに十分な電界を、前記軟部組織に印加して、細胞外空間内への全ての細胞内要素の即座の流出及び前記細胞外空間内への前記細胞膜の内部構成部分の露出を生じさせる工程と、を備え、前記電界は、前記パルス発生器から前記少なくとも一つの電極に、前記電気的膜破壊を生じるように構成された少なくとも一つの両極性電気パルスを送達することによって、前記軟部組織に印加される、請求項43に記載の生体内の免疫学的応答を増加させるための方法。 - 前記免疫学的応答促進剤は、PD‐1及びPD‐L1を含む群から選択されるタンパク質をブロックする、請求項43に記載の生体内の望ましくない軟部組織を切除するための方法。
- 前記免疫学的応答促進剤は、細胞傷害性リンパ球のCTLA‐4抑制シグナルの抑制をブロックする、請求項43に記載の生体内の望ましくない軟部組織を切除するための方法。
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Application Number | Priority Date | Filing Date | Title |
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US201361912172P | 2013-12-05 | 2013-12-05 | |
US61/912,172 | 2013-12-05 | ||
US14/451,333 US10154869B2 (en) | 2013-08-02 | 2014-08-04 | System and method for creating radio-frequency energy electrical membrane breakdown for tissue ablation |
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PCT/US2014/068774 WO2015085162A1 (en) | 2013-12-05 | 2014-12-05 | Cancer immunotherapy by radiofrequency electrical membrane breakdown (rf-emb) |
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US20160367310A1 (en) | 2016-12-22 |
EP3077041A4 (en) | 2017-08-23 |
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US10849678B2 (en) | 2020-12-01 |
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