Pancreatic cancer study with drug-device combination to improve survival

MedTech News: An Australian-first study is underway to determine whether using electrical charges to destroy pancreatic cancer cells can lead to greater survival rates for patients with locally advanced pancreatic cancer.

Pancreatic cancer is the third biggest fatal cancer and it is expected to become the second biggest within a decade. Survival rates have changed little over the last 30 years.

Epworth HealthCare’s four-year DIRECT-INSPIRE study in collaboration with the Walter and Eliza Hall Institute (WEHI) is looking at the use of Irreversible Electroporation (IRE) on patients with unresectable stage 3 pancreatic cancer following first line chemotherapy with Folfirinox or gemcitabine-based chemotherapy.

With IRE, a surgeon implants several small electrodes or NanoKnife into the cancerous tumour. Electrical pluses are then used to puncture nanometre-sized holes in the tumour, causing cancer cells to die.

Consultant cancer surgeon Mr Brett Knowles said AngioDynamics’ NanoKnife gives surgeons an option to treat patients where the pancreatic cancer is intertwined with blood vessels.

“The NanoKnife is the only technology that allows us to destroy the pancreatic cancer without damaging vital structures like blood vessels and the bile duct,” Mr Knowles said.

“There is a minority of patients who have pancreatic cancer, where the cancer doesn’t appear to be able to spread,” Mr Knowles said.

“With these patients, we can deliver effective local treatment with NanoKnife, giving them a safer option for an improved quality of life and survival rate.”

Authors from a recent review published in Techniques in Vascular and Interventional Radiology said “IRE offers locally advanced pancreatic cancer (LAPC) patients an efficacious treatment option when combined with chemotherapy. Several studies have confirmed overall survival benefit compared to current standard-of-care treatment with chemotherapy alone. Nevertheless, due to the possibility of major complications and even death, the procedure should be considered high-risk. In depth knowledge on how to practically perform smart and skilful techniques regarding IRE for LAPC will accomplish safer and more efficacious use of this technique.

“Furthermore, electroimmunotherapy based on the synergy between immunotherapy and IRE represents a new treatment paradigm for interventional radiologists and immuno-oncologists. When smart and strong collaborations are formed, these treatments may have the potential to create a breakthrough in cancer research.”