Digestive Disease Interventions 2020; 04(04): 389-394
DOI: 10.1055/s-0040-1721415
Review Article

Emerging Ablative and Transarterial Therapies for Pancreatic Cancer

Govindarajan Narayanan
1  Miami Cancer Institute, Baptist Health South Florida, Miami, Florida
2  Miami Cardiac and Vascular Institute, Baptist Health South Florida, Miami, Florida
3  Florida International University, Herbert Wertheim College of Medicine, Miami, Florida
,
Antonio Ucar
1  Miami Cancer Institute, Baptist Health South Florida, Miami, Florida
,
Ripal T. Gandhi
1  Miami Cancer Institute, Baptist Health South Florida, Miami, Florida
2  Miami Cardiac and Vascular Institute, Baptist Health South Florida, Miami, Florida
3  Florida International University, Herbert Wertheim College of Medicine, Miami, Florida
,
Arian Nasiri
2  Miami Cardiac and Vascular Institute, Baptist Health South Florida, Miami, Florida
,
Prasuna Inampudi
1  Miami Cancer Institute, Baptist Health South Florida, Miami, Florida
,
Nicole M. Wilson
3  Florida International University, Herbert Wertheim College of Medicine, Miami, Florida
,
Horacio Jose Asbun
1  Miami Cancer Institute, Baptist Health South Florida, Miami, Florida
› Author Affiliations

Abstract

Pancreatic adenocarcinoma is a highly aggressive malignancy with a poor prognosis secondary to late presentation with metastases, challenging resection, and limited alternative therapies. Standard treatment strategies for pancreatic cancer include surgery, chemotherapy, and radiation therapy. These options can extend survival and/or relieve symptoms but are seldom curative. Thermal ablative therapies have been utilized in pancreatic cancer mostly in an open surgical setting. Irreversible electroporation (IRE) is a nonthermal ablative option for pancreatic cancer that uses high voltage, low energy direct current to induce cell death. IRE technology has been shown to spare critical structures such as blood vessels and bile ducts. The safety and efficacy of the percutaneous IRE in Stage 3 pancreas cancer has been studied and there is currently a Food and Drug Administration approved, randomized, controlled trial, and registry enrolling patients in the United States. Recent animal studies have also demonstrated that the advantages of IRE may extend beyond the local tumor effect. In addition to this local ablative option, a phase 3 trial is studying a transarterial option in the management of pancreatic cancer.



Publication History

Received: 23 June 2020

Accepted: 15 September 2020

Publication Date:
19 November 2020 (online)

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