Irreversible Electroporation, or IRE: pulsed elctricity to treat cancers

[Rich66]

Trials:

http://www.clinicaltrials.gov/ct2/re...lectroporation





http://www.healthjockey.com/2007/07/...ectric-pulses/

http://www.bannerhealth.com/About+Us...ver+cancer.htm




Banner Good Samaritan debuts new treatment for liver cancer

Electrical charge directed at tumor cells, leaves healthy tissue intact

Using ultrasound, the interventional radiologost has placed the NanoKnife probes around a liver tumor. Short high-voltage shocks will open the pores in the tumor cells, a process that will eventually kill the tumor cells and allow the healthy liver to regrow.

PHOENIX (July 27, 2009) – Interventional radiologists at Banner Good Samaritan Medical Center recently became the first physicians in the U.S. to use a new image-guided interventional technique to treat liver cancer outside of a clinical trial.
The procedure, called Irreversible Electroporation, or IRE, uses an electric current instead of heat or freezing to permanently open cell membrane pores in the tumor. Once the cell membrane pores are opened, the tumor cells begin to die.
A minimally-invasive system called a NanoKnife delivers electricity to the target cells. The interventional radiologist will use imaging guidance ultrasound or computed tomography (CT) imaging to insert two or more probes into the tumor area. When the NanoKnife probes are in place, the physician then delivers high-voltage electrical pulses through the tumor. The tumor cells receiving the electrical pulses will open their microscopic pores permanently, which ultimately causes the cells to die, dissolve and be removed by the body’s natural processes.
“IRE is a remarkable new minimally-invasive cancer treatment that kills tumors in a completely new way by using high voltage localized electrical current,” said Kevin Hirsch, MD, chairman, Department of Radiology at Banner Good Samaritan. “The tumor cells are killed but the surrounding framework within the liver is left intact as are blood vessels and bile ducts. This allows the normal liver cells to grow into the area that used to be tumor. IRE expands our options for Interventional Oncology treatments and further enables our collaboration with medical oncologists, surgeons, radiation oncologists, and other physicians to provide the best possible treatment for our patients with cancer.”
Charles Raker, MD, who performed the procedure at Banner Good Samaritan, said,“Electroporation had been used before to temporarily open tumor cells, allowing chemotherapy to enter individual cells and kill them from the inside, but the IRE method does not require any chemotherapy. Using the NanoKnife during an IRE procedure allows us to be more precise and much faster, and the procedure spares the healthy parts of the liver. This results in fewer complications and the patient experiences less pain after the procedure.”
Once the tumor cells die, they are carried away by the body’s natural processes, leaving healthy liver tissue to grow and repopulate the area where the tumor was.
The NanoKnife was recently approved by the U.S. Food and Drug Administration for surgical ablation of soft tissue.
About Banner Good Samaritan Medical Center
Banner Good Samaritan Medical Center has been providing medical care to Arizona and the Southwest since 1911. Banner Good Samaritan is owned and operated by Phoenix-based Banner Health, a not-organization. The hospital was named to the 2009-’10 U.S.News & World Report’s “America’s Best Hospitals” list for Gynecology, Heart & Heart Surgery and Kidney Disorders. Banner Good Samaritan has been recognized as a Magnet™ facility by the American Nurses Credentialing Center, the highest honor a hospital can earn for its nursing care and practices, and has been named one of the Best Places to Work in the Valley by The Phoenix Business Journal and BestCompaniesAZ in 2007 and 2008 and one of the “Top 100 Hospitals to Work For” by Nursing Professionals magazine.





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Biomedical engineers use electric pulses to destroy cancer cells

By Lynn A. Nystrom
(540) 231-4371, tansy@vt.edu
Rafael V. Davalos

BLACKSBURG, VA., July 3, 2007 -- A team of biomedical engineers at Virginia Tech and the University of California at Berkeley has developed a new minimally invasive method of treating cancer, and they anticipate clinical trials on individuals with prostate cancer will begin soon.
The process, called irreversible electroporation (IRE), was invented by two engineers, Rafael V. Davalos, a faculty member of the Virginia Tech–Wake Forest University School of Biomedical Engineering and Sciences and Boris Rubinsky, a bioengineering professor at the University of California, Berkeley.
Electroporation is a phenomenon known for decades that increases the permeability of a cell from none to a reversible opening to an irreversible opening. With the latter, the cell will die. What Davalos and Rubinsky did was apply this irreversible concept to the targeting of cancer cells.
“IRE removes tumors by irreversibly opening tumor cells through a series of short intense electric pulses from small electrodes placed in or around the body,” Davalos, the 2006 recipient of the Hispanic Engineer National Achievement Award for Most Promising Engineer or Scientist, said. “This application creates permanent openings in the pores in the cells of the undesirable tissue. The openings eventually lead to the death of the cells without the use of potentially harmful chemotherapeutic drugs.”
The researchers successfully ablated tissue using the IRE pulses in the livers of male Sprague-Dawley rats.
“We did not use any drugs, the cells were destroyed, and the vessel architecture was preserved,” Davalos said.
This work was completed with three additional colleagues, Lluis Mir, director of the Laboratory of Vectorology and Gene Transfer Research of the Institut Gustave Roussy, the leading cancer research center in Europe, and of the Centre National de la Recherche Scientifique (CNRS), Liana Horowitz, a visiting scientist at the University of California, Berkeley, and Jon F. Edd, a doctoral candidate at Berkeley. They reported these in vivo experiments in the June 2006 IEEE Transactions on Biomedical Engineering.
Oncologists already use a variety of methods to destroy tumors using heat or freezing processes, but these current techniques can damage healthy tissue or leave malignant cells. The difference with IRE is Davalos and Rubinsky were able to adjust the electrical current and reliably kill the targeted cells. “The reliable killing of a targeted area with cellular scale resolution without affecting surrounding tissue or nearby blood vessels is key,” Davalos says.
Now, an article by Davalos on IRE is being featured in a special issue of Technology in Cancer Research and Treatment dedicated to this new field. Rubinsky, who holds his Ph.D. from the Massachusetts Institute of Technology, is the guest editor for this special issue, to be published in August, 2007.
At Virginia Tech, Davalos directs the interdisciplinary Bioelectromechanical Systems Laboratory, part of the university’s Institute for Critical Technology and Applied Science (ICTAS) of which the school of biomedical engineering and sciences is a core member. In the Bioelectromechanical Systems Laboratory, other research projects associated with utilizing the physical and electrical characteristics of cells, such as engineering methods for microfluidic single cell analysis, selective cell concentration and image-guided surgery, broaden the understanding and potential of the field of IRE.
“IRE shows remarkable promise as a “minimally invasive, inexpensive surgical technique to treat cancer. It has the advantages that it is easy to apply, is not affected by local blood flow, and can be monitored and controlled using electrical impedance tomography,” Davalos explained. Davalos and other researchers will continue to advance this promising method to treat cancer.




Bioelectromagnetics. 2011 Aug 3. doi: 10.1002/bem.20692. [Epub ahead of print]
Microsecond and nanosecond electric pulses in cancer treatments.

Breton M, Mir LM.

LINK

Source

Université Paris-Sud, Laboratoire de Vectorologie et Thérapeutiques Anticancéreuses, UMR 8203, Orsay, F-91405; CNRS, Orsay, Laboratoire de Vectorologie et Thérapeutiques Anticancéreuses, UMR 8203, F-91405; Institut Gustave Roussy, Laboratoire de Vectorologie et Thérapeutiques Anticancéreuses, UMR 8203, Villejuif 94805. marie.breton@igr.fr.

Abstract

New local treatments based on electromagnetic fields have been developed as non-surgical and minimally invasive treatments of tumors. In particular, short electric pulses can induce important non-thermal changes in cell physiology, especially the permeabilization of the cell membrane. The aim of this review is to summarize the present data on the electroporation-based techniques: electrochemotherapy (ECT), nanosecond pulsed electric fields (nsPEFs), and irreversible electroporation (IRE). ECT is a safe, easy, and efficient technique for the treatment of solid tumors that uses cell-permeabilizing electrical pulses to enhance the activity of a non-permeant (bleomycin) or low permeant (cisplatin) anticancer drug with a very high intrinsic cytotoxicity. The most interesting feature of ECT is its unique ability to selectively kill tumor cells without harming normal surrounding tissue. ECT is already used widely in the clinics in Europe. nsPEFs could represent a drug free, purely electrical cancer therapy. They allow the inhibition of tumor growth, and interestingly, nsPEF can target intracellular organelles. However, many questions remain on the mechanism of action of these pulses. Finally, IRE is a new ablation procedure using pulses that provoke the permanent permeabilization of the cells resulting in their death. This technique does not result in any thermal effect, which is its main advantage in current physical ablation technologies. For both the nsPEF and the IRE, the preservation of the normal tissue, which is characteristic of ECT, has not yet been shown and their safety and efficacy still have to be investigated thoroughly in vivo and in the clinics. Bioelectromagnetics. © 2011 Wiley-Liss, Inc.
Copyright © 2011 Wiley-Liss, Inc.

PMID:

21812011

[PubMed - as supplied by publisher]

Gastroenterol Hepatol (N Y). 2011 May;7(5):313-6.
Irreversible electroporation for treatment of liver cancer.

Narayanan G.

Free PMC Article

Source

Chief of Vascular and Interventional Radiology Miller School of Medicine University of Miami Miami, Florida.

PMID:

21857833

[PubMed - in process]

PMCID: PMC3127037

1: Ann Biomed Eng. 2009 Sep 15. [Epub ahead of print] Links

The Feasibility of Irreversible Electroporation for the Treatment of Breast Cancer and Other Heterogeneous Systems.

Neal RE 2nd, Davalos RV.
Bioelectromechanical Systems, Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences, Virginia Polytechnic Institute and State University, 329 ICTAS Building, Stranger Street, Blacksburg, VA, 24061, USA.
Developments in breast cancer therapies show potential for replacing simple and radical mastectomies with less invasive techniques. Localized thermal techniques encounter difficulties, preventing their widespread acceptance as replacements for surgical resection. Irreversible electroporation (IRE) is a non-thermal, minimally invasive focal ablation technique capable of killing tissue using electric pulses to create irrecoverable nano-scale pores in the cell membrane. Its unique mechanism of cell death exhibits benefits over thermal techniques including rapid lesion creation and resolution, preservation of the extracellular matrix and major vasculature, and reduced scarring. This study investigates applying IRE to treat primary breast tumors located within a fatty extracellular matrix despite IREs dependence on the heterogeneous properties of tissue. In vitro experiments were performed on MDA-MB-231 human mammary carcinoma cells to determine a baseline electric field threshold (1000 V/cm) to cause IRE for a given set of pulse parameters. The threshold was incorporated into a three-dimensional numerical model of a heterogeneous system to simulate IRE treatments. Treatment-relevant protocols were found to be capable of treating targeted tissue over a large range of heterogeneous properties without inducing significant thermal damage, making IRE a potential modality for successfully treating breast cancer. Information from this study may be used for the investigation of other heterogeneous tissue applications for IRE.
PMID: 19757056 [PubMed - as supplied by publisher

1: J Urol. 2008 Dec;180(6):2668-74. Epub 2008 Oct 31. Links

Optimal parameters for the destruction of prostate cancer using irreversible electroporation.

Rubinsky J, Onik G, Mikus P, Rubinsky B.
Department of Mechanical Engineering, University of California-Berkeley, Berkeley, California, USA.
PURPOSE: Irreversible electroporation is a new tissue ablation technique that consists of applying musecond pulses of direct current to create permanent defects in the cell membrane. Irreversible electroporation spares connective tissue in blood vessels and other tissue structures. When applied properly, it does not produce thermal damage. We determined the irreversible electroporation parameters that would reliably destroy prostate cancer cells. MATERIALS AND METHODS: Irreversible electroporation pulses were applied to prostate adenocarcinoma cells in vitro. Three sets of studies were performed to determine the number, length and field strength of irreversible electroporation pulses required to produce complete cancer cell ablation without inducing thermal effects. The outcome of a treatment protocol was simulated. RESULTS: We found the upper and lower limit bounds of pulse length and number in a field range of 2,000 to 250 V/cm. A total of 90 pulses at 250 V/cm for 100 museconds separated by 100 milliseconds could completely ablate prostate cancer cells without inducing thermal damage. CONCLUSIONS: Irreversible electroporation represents a new nonthermal ablation modality. This study has produced values for prostate cancer treatment with irreversible electroporation.
PMID: 18951581 [PubMed - indexed for MEDLINE]