"Electroporation and cancer"

Irreversible Electroporation (IRE) Treatment for Metastatic Disease in Humans is Safer

A brand new, non-invasive treatment that tears tiny holes in tumors without harming healthy tissue is considered as a promising treatment for challenging cancers, suggests an initial study being presented at the Society of Interventional Radiology’s 38th Annual Scientific Meeting in New Orleans.

"Electroporation and cancer"

“Irreversible electroporation (or IRE) is a new way to attack cancer, using microsecond electrical pulses to kill cancer at the cellular level without damaging healthy tissue nearby. It may be especially beneficial in treating liver, lung, pancreatic and other cancers that are close to blood vessels, nerves and other sensitive structures,” said Constantinos T. Sofocleous, M.D., Ph.D., FSIR, lead author and interventional radiologist at Memorial Sloan-Kettering Cancer Center in New York, N.Y. “IRE appears to be especially beneficial in people with cancer that has spread beyond the primary tumor who do not have good treatment options,” he added. “IRE uses strong electric fields to create tiny holes in the cell membrane, killing the cancer by disrupting the balance between the molecules inside and outside the cell—without resulting in other cell damage. This makes IRE potentially ideal for treating tumors close to sensitive structures,” said Sofocleous.

Whereas other treatments—for instance surgery, or heating and freezing (also called thermal ablation)—damages healthy tissue close to the tumor, IRE precisely perforates the cancer cells, posing fewer risks to major arteries and, nerves, bile ducts and also other vital structures, he was quoted saying. IRE is shown to be secure from the treatments for cancers which have metastasized, or spread, to the liver, lung, bladder plus the pelvic region.

On this study, 25 participants that has a total of 40 metastases on the liver from lung, pancreas, thyroid gland, prostate, uterus and uterine lining, ovaries and rectum primaries, were treated with IRE. The normal size of the tumors concerned two centimeters. IRE was adopted as a result of location from the lesions, near critical structures that might be troubled by thermal ablation.

Researchers completed all 30 treatment sessions without having major complications, showing IRE safe enough for additional investigation and expansion of the use to large clinical trials. IRE is around the frontier of interventional radiology treatments which have been nonsurgical and involve minimal risk and downtime for cancer patients. Interventional radiologist treatments involve making incisions the length of a pencil tip and use medical imaging to steer tiny instruments towards the targeted tumors.

“Using the least-invasive treatments available, interventional radiologists are able to destroy entire tumors with a needle and image guidance,” said Sofocleous. “We often treat patients who have no other conventional treatment options or have such poor health that even minimally invasive surgery is too dangerous. Researchers are working to increase the effectiveness of IRE and eventually will test it against other treatments for these tumors, including radiofrequency ablation, microwave ablation and cryoablation,” he noted.

The abstract of this article is given as below.

Purpose:

To investigate the safety of irreversible electroporation (IRE) ablation for treatment of metastatic disease.

Materials:

We performed an Institutional Review Board approved retrospective review of patients treated with IRE for metastatic disease to the liver, bladder, lung, or pelvic soft tissues due to anatomic location close to bile ducts, major vessels, rectum, and nerves. Patient records and imaging studies were examined for tumor type, tumor size, anatomic location and complications.

Results:

Twenty five patients with 40 tumors were treated with IRE in the liver (28), soft tissue (11) and lung (1) for colon cancer (22), pancreatic cancer (6), prostatic cancer (3), rectal cancer (2), endometrial cancer (2), uterine cancer (2) ovarian cancer (1), hemangiopericytoma (1), and thyroid cancer (1). The mean tumor size was 1.9cm (range 1-4cm) in largest cross-sectional diameter. During the 30 treatment sessions there were no major complications. Minor complications included: a transient rise in total bilirubin after three sessions, pneumothorax requiring chest tube insertion after two sessions, transient rise in alkaline phosphatase after two sessions, portal vein thrombosis after one session, transient atrial fibrillation during one session, and urinary retention after one session due to anesthesia.

Conclusions:

IRE, even when preformed in close proximity to bile ducts, major vessels, bladder, rectum, and nerves, has an acceptable safety profile in our experience. Longer term follow up is needed to determine efficacy.

Reference:  “Safety of Irreversible Electroporation (IRE) Treatment for Metastatic Disease in Humans,” M. Silk, T. Wimmer, G. Getrajdman, C.T. Sofocleous, J. Durack, S.B. Solomon, Memorial Sloan- Kettering Cancer Center, New York, N.Y., SIR 38th Annual Scientific Meeting, April 13-18.

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