Electric pulse based technology has been developed and studied as a non-thermal ablation method for local control of pancreatic cancer. Irreversible electroporation (IRE) has shown a significant survival benefit for local advanced pancreatic cancer in clinical trials. However, incomplete ablation with local recurrence and major complications limit the potential of this new technology. We have developed an integrated moderate heating electric pulse delivery system which consists of controllable tumor heating, multi-parameter monitoring and electric pulse delivery. The impedance of tumor is greatly decreased after moderate heating at 42°C for 1–2 min, which does not cause any cell death. Moderate heating significantly enlarges the ablation zone of tumor treated with IRE. In contrast to IRE alone, moderate heating assisted IRE results in a high rate of complete tumor regression and a significant longer median survival. Another electric pulse technology, nanosecond electric pulses, has been assessed for the treatment of pancreatic cancer as well. Nanosecond electric pulse treatment achieves more survival benefit in animals with partial tumor ablation than those treated with IRE and leads to a vaccine-like protective effect in animals with complete local ablation. More studies are needed to demonstrate the advantages and translational feasibility of the enhanced electric pulse technologies.
Part of the book: Advances in Pancreatic Cancer