Irreversible electroporation has “potential to become new standard of care” in prostate cancer treatment

Irreversible electroporation to treat prostate cancer

A new study presented at the Cardiovascular and Interventional Radiological Society of Europe (CIRSE 2016, 10–14 September, Barcelona, Spain) meeting finds that the treatment of prostate cancer with irreversible electroporation is efficacious and safe.

Michael K Stehling, professor of Radiology, Prostate Center, Institut für bildgebende Diagnostik, Offenbach am Main, Germany, and colleagues reported an impotence rate of 15% and zero incontinence observed in the study.

“Irreversible electroporation is suitable for prostate cancer recurrences after any previous treatment. MRI is a powerful tool for diagnosis and follow-up, but should be combined with 3D biopsy for optimal treatment planning. Irreversible electroporation has the potential to become the new standard of care in the treatment of prostate cancer,” Stehling told the CIRSE audience.
As reported by the authors, “Irreversible electroporation is a novel tissue ablation modality which selectively destroys cells whilst preserving non-cellular tissue. It has low toxicity on critical anatomical structures and may thus be an ideal therapy for prostate cancer, since it has the potential to avoid side effects of surgical/radiation treatment of prostate cancer such as impotence, incontinence and rectal damage.”

The investigators treated 300 patients with T1–T4 and recurrent prostate cancer with irreversible electroporation in the last five years. All treatments were based on multiparametric magnetic resonance imaging, while in 136 patients, additional transperineal 3D biopsy was performed.

Patients were treated under general anaesthesia and deep muscle relaxation. The physicians placed the probes by means of transrectal ultrasound guidance. All patients had follow-up MRI 24 hours post-treatment and further follow-up by MRI and prostate-specific antigen testing at three, six and 12 months, and then annually.

“The initial ablation of cancerous tissue was successful in all patients. We report recurrent disease in 5% of all cases during follow-up. No life-threatening and four medically significant adverse events occurred. Potency was transiently reduced in 15.2% and persistently reduced in 8.4% of surveyed patients. Continence was preserved in all cases,” Stehling reported.
In December 2015, in a Radiological Society of North America (RSNA) press release on treating prostate cancer with irreversible electroporation, Stehling commented: “Treating prostate cancer with minimal pain and minimal risk of impotence and incontinence, even in patients with advanced and recurrent cancer, with a one-time, one-day treatment, until recently, was unthinkable. The cutting edge technology of irreversible electroporation makes this a reality.”