First Use of Innovative “IRE” on Pancreatic Tumor

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A new procedure for treating pancreatic and liver cancers using electrical fields to poke holes in tumors was used for the first time anywhere to fight pancreatic cancer at Stony Brook University Medical Center by Kevin Watkins, M.D., Chief of the Upper Gastrointestinal and General Oncologic Surgery Group.

The procedure, performed at SBUMC in December 2009, is called “irreversible electroporation (IRE),” a minimally invasive surgical technique (also referred to as a “NanoKnife®”) that selectively kills the cancer by using electrical fields to generate pores in tumor cells.

Dr. Watkins used IRE to treat a typically fast growing and fatal tumor, pancreatic cancer. This marked both the first use of IRE at SBUMC and the first-ever use of the technique on a pancreatic tumor. Another pancreatic cancer patient is scheduled for the procedure during March 2010.

“Our first IRE patient had her six-week follow-up PET scan in early February, and the initial report showed no activity, making her a radiographic complete response at this point,” Dr. Watkins said. “Hopefully, she’ll have a durable response, which only time will tell, but from a local disease standpoint, the technology did just what we had hoped.”

The patient at SBUMC was Mary Ciccariello, 79, of Smithtown, who was home four days after her surgery. “It will hopefully help other people,” Ann Marie Ciccariello, the patient’s daughter-in-law, said of the procedure. She added that the family was very pleased by the procedure and the experience they had at SBUMC. “They took very good care of her, and Dr. Watkins was very good also.”

Electroporation is the process of using brief and controlled electric pulses to open microscopic pores in a targeted area. By increasing the number, strength, and duration of electric pulses, electroporation can be made permanent, or irreversible. After IRE, the pores in the cells remain open permanently. This causes microscopic damage to the cells, and they die.

IRE technology allows for extreme precision. While targeted soft-tissue cells are killed, blood vessels and other important structures in the area remain functional. The body is able to naturally rid itself of the dead cells. In regenerating organs, such as the liver, the dead cells are replaced with healthy cells.

IRE does not generate heat or cold, which could damage normal adjacent tissues. The combination of minimally invasive surgery and IRE allows for faster recovery with less tissue injury, and it is hoped, a better long-term outcome than with traditional surgery. At a minimum, patient quality of life improves in the near term. The proprietary device that generates IRE is approved for the ablation of soft tissue. It is being used for lung, liver, and kidney tumors as well. Dr. Watkins hopes to establish protocols to demonstrate its utility and safety, which will be used by the Food and Drug Administration (FDA).

Dr. Watkins said that in general new minimally invasive surgical methods offer patients the possibility of diminished postoperative pain, less scarring, fewer complications post-surgery and earlier discharge from the hospital. The approaches may also help patients heal quicker, which may be crucial if they need to undergo additional treatment such as chemotherapy or radiation.

Source:  Stony Brook University Medical Center

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