Systematic review of irreversible electroporation in the treatment of advanced pancreatic cancer

Moir, John; White, Steven A.; French, Jeremy; Littler, Peter; Manas, Derek

doi:10.1016/j.ejso.2014.08.480

Cited by 71 publications

(49 citation statements)

References 33 publications

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“…For these patients, systemic therapy with or without radiation has been the standard of care (3,4). Although new chemotherapy regimens such as FOLFIRINOX (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) and the addition of nabpaclitaxel to gemcitabine are resulting in improved survival, the prognosis for locally advanced pancreatic cancer remains dismal (5,6).…”

Section: Implications For Patient Carementioning

confidence: 99%

Ablation of Locally Advanced Pancreatic Cancer with Percutaneous Irreversible Electroporation: Results of the Phase I/II PANFIRE Study

Scheffer¹,

Vroomen²,

Jong³

et al. 2017

Radiology

109

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Purpose To (a) investigate the safety of percutaneous irreversible electroporation (IRE) for locally advanced pancreatic cancer and (b) evaluate the quality of life (QOL), pain perception, and efficacy in terms of time to local progression, event-free survival, and overall survival (OS). Materials and Methods The study was approved by the local review board (NL42888.029.13). All patients provided written informed consent for study participation, the ablation procedure, and data usage. Between January 2014 and June 2015, 25 patients with histologically proved locally advanced pancreatic cancer 5 cm or smaller (13 women, 12 men; median age, 61 years; age range, 41-78 years) were prospectively included to undergo percutaneous computed tomographic-guided IRE. Patients with a metallic biliary Wallstent, epilepsy, or ventricular arrhythmias were excluded. Kaplan-Meier estimates were used to investigate time to local progression, event-free survival, and OS. Safety was assessed on the basis of adverse events, which were graded according to the Common Terminology Criteria for Adverse Events. Pain perception and QOL were evaluated by using specific questionnaires. Results All patients underwent IRE. The median largest tumor diameter was 4.0 cm (range, 3.3-5.0 cm). After a median follow-up of 12 months (interquartile range: 7-16 months), median event-free survival after IRE was 8 months (95% confidence interval [CI]: 4 months, 12 months); the median time to local progression after IRE was 12 months (95% CI: 8 months, 16 months). The median OS was 11 months from IRE (95% CI: 9 months, 13 months) and 17 months from diagnosis (95% CI: 10 months, 24 months). There were 12 minor complications (grade I or II) and 11 major complications (nine grade III, two grade IV) in 10 patients. There were no deaths within 90 days after IRE. Conclusion Percutaneous IRE for locally advanced pancreatic cancer is generally well tolerated, although major adverse events can occur. Preliminary survival data are encouraging and support the setup of larger phase II and III clinical trials to assess the efficacy of IRE plus chemotherapy in the neoadjuvant and adjuvant or second-line setting compared with more widely adopted regimens such as chemotherapy and/or radiation therapy. RSNA, 2016 Online supplemental material is available for this article.

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Section: Implications For Patient Carementioning

confidence: 99%

Ablation of Locally Advanced Pancreatic Cancer with Percutaneous Irreversible Electroporation: Results of the Phase I/II PANFIRE Study

Scheffer¹,

Vroomen²,

Jong³

et al. 2017

Radiology

109

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“…A total of ~227,000 patients are estimated to succumb to mortality from pancreatic cancer each year worldwide (2). The validated risk factors of pancreatic cancer include smoking, high-fat and high-protein diet, excessive drinking, high coffee consumption, exposure to certain chemical carcinogens, diabetes and chronic pancreatitis (3)(4)(5). Pancreatic ductal adenocarcinoma (PDAC) is a major type of primary pancreatic cancer and accounts for 96% of all cases of pancreatic cancer (6).…”

Section: Introductionmentioning

confidence: 99%

MicroRNA‑874 inhibits proliferation and invasion of pancreatic ductal adenocarcinoma cells by directly targeting paired box 6

Diao

Cao

et al. 2018

Mol Med Report

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Studies have demonstrated that a number of microRNAs (miRNAs) are dysregulated in pancreatic ductal adenocarcinoma (PDAC), and alterations in their expression may affect the onset and progression of PDAC. Therefore, the expression patterns, biological functions and associated molecular mechanisms of miRNAs in PDAC should be elucidated for the development of novel therapeutic methods. Previous studies reported significant miRNA‑874 (miR‑874) dysregulation in multiple types of human cancer. However, the expression pattern, possible roles and underlying mechanisms of miR‑874 in PDAC remain to be elucidated. This study evaluated miR‑874 expression in PDAC and examined its biological functions and underlying mechanism of action in PDAC progression. miR‑874 expression was downregulated in PDAC tissues and cell lines. Functional experiments demonstrated that upregulation of miR‑874 inhibited cell proliferation and invasion in PDAC. Additionally, paired box 6 (PAX6) was predicted as a putative target of miR‑874 using bioinformatics analysis. Further experiments demonstrated that PAX6 may be the direct target gene of miR‑874 in PDAC. PAX6 knockdown exhibited similar inhibitory effects to miR‑874 overexpression in PDAC cells. In addition, restored PAX6 expression may reverse the suppressive roles of miR‑874 overexpression in PDAC cells. The results demonstrated that miR‑874 may serve tumor suppressive roles in PDAC by directly targeting PAX6. Therefore, miR‑874 may exhibit potential applications for treatment of patients with PDAC.

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“…Depending on the study design, a 6-month survival of 40 % and 70 % and a PFS and OS of 14 and 20 mo, respectively, were reported. Compared to non-IRE groups lung metastases within 30 days (n = 1, 10 %), liver metastases within 60 days (n = 2, 20 %); OS was 7.5 mo (range, 2.5 -15.9 mo); n = 9 died from disease, n = 1 died of septic shock 2 weeks after IRE; PR in n = 4 (40 %), PD in n = 3 (30 %) and SD in n = 3 (30 %) (RECIST) (PFS of 6 and OS of 11 mo), a prognostic benefit for IRE became apparent [39]. To sum up, IRE has repeatedly proven to prevent recurrence and hold back local progression with a prognostic benefit in patients with LAPC (• ▶ Fig.…”

Section: Pancreasmentioning

confidence: 99%

Irreversible Electroporation in Interventional Oncology: Where We Stand and Where We Go

Savic¹,

Chapiro²,

Hamm³

et al. 2016

Fortschr Röntgenstr

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▶ Durch nicht-thermische Ablation können "heatsink-effect" und Koagulationsverletzungen unbeteiligter Strukturen umgangen werden. Abstract ▼Irreversible electroporation (IRE) is the latest in the series of image-guided locoregional tumor ablation therapies. IRE is performed in a nearly nonthermal fashion that circumvents the "heat sink effect" and allows for IRE application in proximity to critical structures such as bile ducts or neurovascular bundles, where other techniques are unsuitable. IRE appears generally feasible and initial reported results for tumor ablation in the liver, pancreas and prostate are promising. Additionally, IRE demonstrates a favorable safety profile. However, site-specific complications include bile leaking or vein thrombosis and may be more severe after pancreatic IRE compared to liver or prostate ablation. There is limited clinical evidence in support of the use of IRE in the kidney. In contrast, pulmonary IRE has so far failed to demonstrate efficacy due to practicability limitations. Hence, this review will provide a state-of-the-art update on available clinical evidence of IRE regarding feasibility, safety and oncologic efficacy. The future role of IRE in the minimally invasive treatment of solid tumors will be discussed.

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Systematic review of irreversible electroporation in the treatment of advanced pancreatic cancer

Cited by 71 publications

References 33 publications

Ablation of Locally Advanced Pancreatic Cancer with Percutaneous Irreversible Electroporation: Results of the Phase I/II PANFIRE Study

Ablation of Locally Advanced Pancreatic Cancer with Percutaneous Irreversible Electroporation: Results of the Phase I/II PANFIRE Study

MicroRNA‑874 inhibits proliferation and invasion of pancreatic ductal adenocarcinoma cells by directly targeting paired box 6

Irreversible Electroporation in Interventional Oncology: Where We Stand and Where We Go

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