Abstract

Abstract Introduction: Cervical cancer, although largely preventable, continues to be a significant health concern. Early-stage treatment is commonly surgery; while advanced, recurrent, or metastatic disease often requires systemic therapy. Chemotherapy, mainly cisplatin is the backbone of first-line therapy. TTFields are electric fields that disrupt cellular processes critical for cancer cell viability and tumor progression. In other tumor types, TTFields applied with cisplatin has exhibited benefit. This in vitro study assessed the preclinical efficacy of TTFields for cervical cancer and explored efficacy for concurrent use with cisplatin. Methods: Effects on cell count in cervical cancer cell lines exposed to TTFields (0.5 V/cm for Ca Ski cells, 1 V/cm RMS for HeLa and SiHa cells; 72 h) across a range of frequencies (100-400 kHz) were evaluated. TTFields (200 kHz) were then applied with varying cisplatin doses followed by cell count, colony formation, and apoptosis assays. Overall effect was calculated as the product of percent reductions in cell count and colony formation. TTFields-treated cells were evaluated for formation of the DNA damage marker γH2AX using fluorescent microscopy; and for the expression of Fanconi Anemia (FA)-BRCA pathway proteins through Western blotting. Results: TTFields treatment reduced cell count in all cervical cancer cell lines tested. Cisplatin exhibited dose-response effects, which were enhanced when TTFields were co-applied. TTFields led to downregulated expression of FA-BRCA pathway proteins, which are involved in repairing cisplatin-induced DNA damage, resulting in increased DNA damage. Conclusions: These preclinical results suggest that TTFields should be further explored as a potential treatment for cervical cancer. TTFields-induced downregulation of the FA-BRCA pathway possibly explains the enhanced efficacy when TTFields are applied together with cisplatin, providing mechanistic insight. Citation Format: Roni Frechtel-Gerzi, Daria Gerasimova, Einav Zeevi, Roni Monin, Hila Fishman, Inbar Schlachet-Drukerman, Helena Mumblat, Antonia Martinez-Conde, Rotem Engelman, Eyal Dor-On, Itai Tzchori, Adi Haber, Moshe Giladi, Uri Weinberg, Yoram Palti, Greg M. Palmer, Angeles Alvarez Secord. Preclinical investigations of concomitant tumor treating fields (TTFields) with cisplatin for treatment of cervical cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7219.

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