Ablative therapies are increasingly being used in the management of locally advanced pancreatic cancer (LAPC). Now, a new study has found that adding irreversible electroporation (IRE) to conventional chemotherapy and radiation therapy may result in substantially prolonged survival compared with historical controls in patients with stage 3 LAPC.1
“The key really is good patient selection and optimal IRE delivery technique,” said study investigator Robert Martin II, MD, PhD, director of surgical oncology at the University of Louisville in Louisville, KY.
“The complications were minor. The most common complication was related just to standard surgical procedure, which is slow return of GI function.”
He said the appropriate and precise use of IRE in appropriately selected patients with locally advanced pancreatic cancer can result in a median overall survival (OS) close to 24 months, which is nearly double the survival rate than with the best new chemotherapy and chemo-radiotherapy.
Dr. Martin and colleagues looked at outcomes in 200 patients with radiographic stage 3 LAPC who underwent induction chemotherapy for a median of 6 months (range: 5 to 13 months).
Among the 200 patients, 52% received chemo-radiotherapy and IRE was successfully performed in all 200 patients. The mean age of the patients was 62 years (range: 27 to 88 years) and 101 of the 200 were male.
After a median follow-up of 29 months, the researchers found that only 6 patients (3%) had experienced local recurrence and the median OS was 24.9 months (range: 4.9 to 85 months).1
IRE uses ultra-short but strong electrical fields to create holes in cell membranes, ultimately leading to cell death. The main use of IRE lies in tumor removal in regions where precision and conservation of the basic cellular matrix, blood flow, and nerves are of importance. IRE is commonly performed as an open surgery and usually requires a 5- to 7-day hospital stay and a 2- to 3-week recovery for the patient to get back to their baseline quality of life.
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All of the patients in this cohort were treated between July 2010 and October 2015, at six institutions and 37% of patients sustained complications with a median grade of 2 (range: 1 to 5). The median length of stay in the hospital was 6 days (range: 4 to 36 days).