Percutaneous Irreversible Electroporation Ablates Pancreatic Tumors

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(ChemotherapyAdvisor) – Percutaneous irreversible electroporation (IRE) is feasible and safe in patients with locally advanced pancreatic adenocarcinoma, with two of eight patients with unresectable disease achieving a margin-negative resection, according to a study presented during the Society of Interventional Radiology's 37th Annual Scientific Meeting in San Francisco, CA, USA, on March 26.

IRE is performed using the NanoKnife System (AngioDynamics, Latham, NY) which has received clearance from the U.S. Food and Drug Administration for the surgical ablation of soft tissue. Previously, IRE has been successful in treating primary and metastatic liver cancer and is now in the first stages of implementation as a treatment for pancreatic cancer.

The investigators reviewed records of eight patients who had undergone percutaneous ablation of pancreatic tumors using IRE between December 2010 and September 2011. Median age was 53 years (range 51–72), median time from diagnosis to IRE was 8.8 months (range 2.4–29.2), and median tumor size was 2.8cm (range 2.5–6.8). All patients had received chemotherapy and seven, prior radiation; median lines of prior therapies was two (range 1–4).

Immediate and 24-hour postprocedure CT with contrast demonstrated patent vasculature in the treatment zone in all patients. Two patients underwent surgery four and five months after IRE, respectively. Both had margin-negative resections and one had a pathologic complete response. Both remain disease-free at two and six months after resection, respectively.

Among the six remaining patients, two were lost to follow-up and one had progressive disease after three months; one had a negative follow-up PET scan and surgery was planned. The two remaining patients are under follow-up to determine resectability. Complications included spontaneous pneumothorax during anesthesia (n=1) and pancreatitis (n=1); both patients recovered completely.

A prospective neoadjuvant trial in patients with locally advanced pancreatic adenocarcinoma incorporating IRE is planned.


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