{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T05:09:38Z","timestamp":1775797778741,"version":"3.50.1"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Pulsed Electric Field (PEF) ablation is a non-thermal cancer treatment that disrupts tumor cell membranes while preserving the immune microenvironment and promoting immunogenic cell death. We present a case of a patient with metastatic hormone receptor-positive, HER2-low breast cancer who achieved a durable clinical response after PEF in combination with an immune checkpoint inhibitor (pembrolizumab). The patient remained off systemic therapy for 14 months without disease progression. Single-cell spatial molecular imaging (SMI) and gene set enrichment analysis (GSEA) were performed to evaluate immune microenvironment changes pre- and post-PEF treatment. Spatial transcriptomics of the tumor cell compartment revealed a post-PEF enrichment of immune-related pathways, including interferon alpha\/beta and gamma signaling and MHC class I antigen processing and presentation, alongside increased infiltration of immune cells: CD8+ T cells, plasmablasts, and monocytes within the tumor neighborhood. This hypothesis-generating case suggests PEF\u2019s potential to reshape the tumor-immune microenvironment when combined with immune checkpoint blockade, warranting further studies on its role in combination immunotherapy strategies.<\/jats:p>","DOI":"10.3389\/fonc.2026.1681010","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T04:27:41Z","timestamp":1775795261000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: durable response to pulsed electric field ablation in combination with immune checkpoint inhibitors in HER2-low breast cancer through activation of interferon signaling"],"prefix":"10.3389","volume":"16","author":[{"given":"Yi","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic","place":["Jacksonville, FL, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia","family":"De La Garza-Ramos","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, Department of Radiology, Mayo Clinic","place":["Jacksonville, FL, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel","family":"Gabriel","sequence":"additional","affiliation":[{"name":"Department of Surgery, Mayo Clinic","place":["Jacksonville, FL, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aziza","family":"Nassar","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Mayo Clinic","place":["Jacksonville, FL, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beau","family":"Toskich","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, Department of Radiology, Mayo Clinic","place":["Jacksonville, FL, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. Aubrey","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Cancer Biology, Mayo Clinic","place":["Jacksonville, FL, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saranya","family":"Chumsri","sequence":"additional","affiliation":[{"name":"Department of Cancer Biology, Mayo Clinic","place":["Jacksonville, FL, United States"]},{"name":"Department of Hematology-Oncology, Mayo Clinic","place":["Jacksonville, FL, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15133340","article-title":"Pulsed electric fields in oncology: A snapshot of current clinical practices and research directions from the 4th world congress of electroporation","volume":"15","author":"Campana","year":"2023","journal-title":"Cancers 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