Safety and Feasibility of Electrochemotherapy of the Pancreas in a Porcine Model

Abstract

Objectives The use of thermal ablative therapies in the pancreatic tumors is limited because of the risk of the vessel injury and potential pancreatitis or fistula formation. Electrochemotherapy (ECT) is an ablative therapy with an established role in the treatment of cutaneous and liver tumors. This study was designed to evaluate the safety and feasibility of ECT of the pancreas in a porcine survival model. Methods In the first group, 4 animals underwent computed tomography (CT)–guided percutaneous ECT with bleomycin of the pancreatic tail. In the second group (4 animals), the intraoperative ECT with bleomycin of pancreatic tail and head was performed. Animals were followed for 7 days and then killed. Clinical parameters, CT imaging, laboratory, and histologic analysis were performed. Results All pigs survived the ECT procedure and none of them developed clinical signs of acute pancreatitis or related complications. There were no signs of acute pancreatitis or damage to the large vessels present in the follow-up CT scans. No significant change in laboratory parameters was obtained after procedure. Conclusions This study shows that ECT with bleomycin is feasible and safe in the pancreatic parenchyma. Clinical studies are needed to evaluate the efficacy of ECT in pancreatic cancer.

Assessment of Ablation Therapy in Pancreatic Cancer: The Radiologist’s Challenge

“…Formation of the aqueous pores in the lipid bilayer is the widely recognized mechanism, but evidence is growing that individual membrane lipids and proteins changes also contribute at ECT cytotoxic effect (61). The increased accumulation of intracellular drug concentration has actually been shown both in vitro and in vivo (58,(62)(63)(64)(65).…”

Pharmacokinetics of carprofen in anaesthetized pigs: a preliminary study

“…The pig is a common research model for translational medicine due to its anatomical and physiological resemblance to humans and was therefore selected for our research on the effects of electroporation (Djokic et al 2018;Campana et al 2019) on the pancreas (Dežman et al 2020).…”

Sunitinib potentiates the cytotoxic effect of electrochemotherapy in pancreatic carcinoma cells

“…Its feasibility and safety were demonstrated in preclinical studies in porcine and rabbit models. 11 , 12 This was also confirmed in a few clinical studies demonstrating the feasibility and safety of the treatment in a palliative setting. 13 , 14 , 15 However, there is a lack of preclinical studies assessing the actions of different drugs used in ECT, their mechanisms and interactions with targeted drugs that are used in clinical practice.…”

“…The feasibility and safety of this approach was established in preclinical studies in a porcine and rabbit models, where it was demonstrated that ECT with bleomycin does not cause devastating complications such as acute pancreatitis, pancreatic fistula, or vascular injury. 11 , 12 The first clinical studies were also conducted, demonstrating the feasibility and safety of the treatment in a palliative setting. 13 , 14 , 15 However, there is a lack of preclinical studies assessing the actions of different drugs used in ECT, their mechanisms and interactions with targeted drugs, which are currently used in clinical practice for the treatment of pancreatic cancer.…”