Electrical Pulse Treatment Promising in Pancreatic Cancer

Laird Harrison

April 05, 2012

April 4, 2012 (San Francisco, California) — A preliminary study of irreversible electroporation (IRE) for pancreatic cancer showed good results, researchers reported here at the Society of Interventional Radiology 37th Annual Scientific Meeting.

IRE uses high-voltage microsecond electrical pulses to break open and destroy tumor cells around the delicate network of blood vessels of the pancreas.

"This is very precise," researcher Govindarajan Narayanan, MD, chief of vascular and interventional radiology at the University of Miami in Florida, told Medscape Medical News. "You can decide what zone you want and use the appropriate number of needles."

IRE, which has shown promise in primary and metastatic liver cancer, is now in the first stages of implementation as a treatment for pancreatic cancer.

Pancreatic tumors are difficult to treat because using heat or cold to remove the cancer can damage blood vessels in and around the organ.

An estimated 44,000 people will be diagnosed with pancreatic cancer and approximately 37,390 people will die of the disease this year, according to American Cancer Society statistics.

Dr. Narayanan presented data on 15 patients with advanced pancreatic cancer: 3 with metastatic disease and 12 with locally advanced pancreatic cancer. The median tumor size was 3.3 cm.

The normal survival time from diagnosis in such patients is 12 to 18 months. The patients in this study were treated with IRE 2.4 to 49.5 months after diagnosis, and survived a median of 6.7 months after receiving IRE.

Three patients with metastatic cancer and 1 with locally advanced cancer have died. Autopsies indicated that the deaths were not related to IRE.

Two of the patients have successfully downstaged and are still without evidence of disease. One of them has so far lived 421 days without signs of recurrence.

Potential risks include injury to blood vessels from the needle itself. Also, patients with cardiac issues, such as atrial fibrillation, are not good candidates because their conditions could be adversely affected by the electricity.

None of the patients in this study experienced such adverse events.

IRE is performed with a system called the NanoKnife, developed by AngioDynamics. It is in the premarket notification stage (meaning the manufacturers have filed intent to market the device) with the US Food and Drug Administration and can be used off label.

Asked to comment, Mark Garcia, MD, section chief of interventional radiology at Christiana Care in Newark, Delaware, told Medscape Medical News that there are not yet enough data to pass judgment on IRE, but that the concept is promising.

"I think the technology is very interesting," he said. "I think it's potentially a leap forward from the therapies we have now."

Dr. Garcia has disclosed no relevant financial relationships. Dr. Narayanan reports receiving honoraria from AngioDynamics.

Society of Interventional Radiology (SIR) 37th Annual Scientific Meeting: Abstract 8. Presented March 27, 2012.

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