Researchers investigating an alternative to current therapies for HPV-caused cancers have found that a Scots health tech company’s microwave device delivers targeted treatment to cancerous cells and may reduce the impact of treatment for patients.

The medical device from Stirling-based Emblation is already being used to treat warts. Now independent research into its potential to treat precancerous and cancerous tissues by inducing cancer cell death has been published.

More than 99% of cervical cancers are caused by high risk human papillomavirus varients (HR-HPV) and despite preventative strategies including national teenage vaccination programmes, HPV-related cancer remains high – accounting for 630,000 cancer cases globally ever year.

Currently, the effective treatments include cauterisation or “loop” excision of the cervix, effectively burning or cutting away the cancerous or pre-cancerous tissue and some of the surrounding tissue. While treatment plans vary depending on the stage of cancer, where it is and other health factors for the patient, these treatments can cause discomfort, inflammation or some  bleeding.

The search has been on for a less invasive, less painful and more effective treatment for cervical cancer patients.

University of Glasgow researchers, writing in the medical journal, The Lancet, have concluded that Emblation’s Swift® device delivers ‘precise tissue disruption’ to destroy cancerous cells in a process known as microwave hyperthermia.

Professor Sheila Graham, the University of Glasgow’s Professor of Molecular Virology, who led the research, told healthandcare.scot that compared to other treatments, this is mild and highly localised.

Dr Matt Kidd, Director of Research and Development, at Emblation, said:

“This is a first and absolutely vital step toward eventually getting tests out of the lab and into medical situations involving real patients.

“While we were delighted to provide a Swift device for the research and helped train the scientists in how to use it, we had no involvement in the experiments. So, we have been genuinely thrilled to read about the highly-promising results in The Lancet.”

The evaluation

In this research, Professor Graham, and her team grew 3D precancerous and cancerous cells in vitro (in the lab) and used the Swift® probe to target microwaves at the cells.

As microwaves are ‘non-ionising’ forms of radiation, they can disrupt cells by supplying energy to agitate water molecules without deeply damaging surrounding tissues or affecting DNA. Professor Graham explained how the treatment harnesses this:

“The technology gives the opportunity to precisely target lesions without affecting surrounding tissue.

“The technology induces mild heating in the tissues and causes cells to die. In contrast current therapies for anogenital precancers and cancers involve surgical removal of tissue or, for genital warts, cryotherapy which is used alongside topical treatments which are painful to use.”

By using this lower-energy form of radiation in microwaves, water molecules in the cells begin to collide rapidly, creating friction which leads to a temperature rise. This creates a two-fold response to tackle the cancer in the tissues.

The temperature generated is enough to heat the cells up to 45-48C and induce what is known as a “heat shock response” which stops most proteins being made in the cells leading to cell death.

While this process prevents the viral cancer-causing proteins from developing, Professor Graham added that the heat shock response also activates a protein called p53 and increases the levels of this in the cells.

She explained that as a tumour antigen, p53 is key detector of stress in cells and induces cell death by apoptosis – effectively the cell’s self-destruction mechanism.

Funded by a Chief Scientist Office grant, the Glasgow scientists found that using the microwave device had little impact on surrounding tissues, which can regenerate to repair the affected area.

The researchers also reported the device triggered an immune T-cell response.

Professor Graham said:

“The treatment is mild, highly localised and the energy applied to tissues can be finely calibrated for each type of application. Most importantly, we have shown by our research that microwaving can stop HPV making the proteins which cause cancer formation, and the device also has the ability to enhance the immune response against the virus. Current treatments don’t target the virus.”

The team’s report states that existing treatments for cervical cancers and precancers are effective but, alongside pain and potential bleeding, they can increase the risk of future pre-term births.

It goes on to say microwave therapy may prove to be “better tolerated” by patients and save time and resources for clinicians and healthcare systems.

The Swift device is already in use all over the world, particularly by podiatrists for treating stubborn verrucae – which are also caused by strains of HPV. However, as it is currently only approved by regulators for skin applications and not the tissues where HPV-associated diseases occur, a clinical trial is needed.

Professor Graham said the team will now finalise and publish the research investigating the detailed impact of microwave therapy on the immune response to HPV infections before moving into clinical trials.

Dr Kidd added:

“Our technology has already delivered game changing results in podiatry and dermatology – but all of us at Emblation believe we have only just started to unlock the true potential of microwave therapies.

“We will continue to support research whenever we can that helps show how our devices may be beneficial in treatments from cancer to cardiac conditions.”

Read more: Cervical cancer unit to treat patients in 30 minutes; Pandemic impact on cancer incidence in Scotland; Funding boost for hepatology research; Scottish health tech firm launches $2m clinical trial

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