Electrochemotherapy in pancreatic adenocarcinoma treatment: pre-clinical and clinical studies

Abstract

BackgroundPancreatic adenocarcinoma is currently one of the deadliest cancers with high mortality rate. This disease leads to an aggressive local invasion and early metastases, and is poorly responsive to treatment with chemotherapy or chemo-radiotherapy. Radical resection is still the only curative treatment for pancreatic cancer, but it is generally accepted that a multimodality strategy is necessary for its management. Therefore, new alternative therapies have been considered for local treatment.ConclusionsChemotherapeutic resistance in pancreatic cancer is associated to a low penetration of drugs into tumour cells due to the presence of fibrotic stroma surrounding cells. In order to increase the uptake of chemotherapeutic drugs into tumour cells, electrochemotherapy can be used for treatment of pancreatic adenocarcinoma leading to an increased tumour response rate. This review will summarize the published papers reported in literature on the efficacy and safety of electrochemotherapy in pre-clinical and clinical studies on pancreatic cancer.

Electrochemotherapy Causes Caspase-Independent Necrotic-Like Death in Pancreatic Cancer Cells

“…Development of endoscopic devices such as the Endove or expandable probes [41] would give ECT the potential to effectively treat tumours that are surrounded by vital structures such as larger blood vessels, nerves, and viscera without damage to them and without side effects or major complications, so rendering PC a viable candidate [42]. Indeed, ECT has already been used in a number of preliminary studies in PC with promising results [43].…”

A Comprehensive Review of Calcium Electroporation—A Novel Cancer Treatment Modality

“…The first clinical trial using reversible electroporation in combination with a chemotherapeutic drug (electrochemotherapy) was performed in 1990-1991 [6]. Since then several clinical trials using electrochemotherapy have been performed for treatment of small tumors, such as cutaneous and subcutaneous metastases [7][8][9][10]14,64,65], for larger tumors such as chest wall breast cancer recurrences [11,66], as well as for treatment of tumors in internal organs and deep seated tumors [67][68][69][70][71]. Electroporation is also investigated for use in gene electrotransfer where it can be used for DNA vaccine [72] and treatment of cancers [73,74].…”

Locally Advanced Pancreatic Cancer: A Review of Local Ablative Therapies

“…This allows for extracellular agents to access the cells. Reversible electroporation combined with chemotherapeutic agents (ECT) may improve their uptake, in particular for drugs that are poorly, or not, permeant [ 20 ].…”