ELECTROCHEMOTHERAPY IN THE TREATMENT OF UNRESECTABLE PANCREATIC CANCER

Abstract

Pancreatic cancer (PC) is a malignant tumor with a poor prognosis and an extremely low 5-year survival rate. No more than 10% of patients have local cancer of the pancreas; in the rest, at the time of the initial diagnosis, it is already a systemic disease. In most patients, relapse occurs within the first 6 months after resection and adjuvant therapy. 95% of patients with prostate cancer require palliative therapy. For 40 years, the results of treatment of metastatic prostate cancer have improved slightly. Gemcitabine monotherapy increased overall survival to 6 months; combinations of gemcitabine with nab-paclitaxel, liposomal irinotecan with 5-FU, or FOLFIRINOX triplet did not achieve 1-year survival. To date, the survival limit of patients has been reached, and the likelihood of a radical change in the treatment paradigm over the next five years is very small. The results of current clinical trials examining the effects of new drugs in prostate cancer can be expected in about 8-10 years, with an estimated success rate of about 3%. A new method of local tumor ablation, which combines intravenous administration of cytostatics (for example, cisplatin or bleomycin) with exposure of tumor cells to constant currents with extremely short and intense pulses (8 nano-pulses of 100 microseconds duration), is the method of electrochemotherapy (clinical therapy). Unlike radiofrequency, microwave or laser ablation, in which tissues are destroyed as a result of high temperatures with the formation of a zone of coagulation necrosis, the method of electroporation is not associated with thermal exposure, it is safer and can be used in various clinical situations, including in the treatment of cancer. pancreas. Dynamic Electro-Amplified Chemotherapy (D-EECT) is a safe, simple and effective clinical method for treating large tumor masses. This method opens up a new direction and creates good prospects in the treatment of inoperable, chemoresistant and radioresistant tumors. In some studies, the median time to progression (PFS) and overall survival (OS) from the moment of diagnosis in patients with unresectable prostate cancer was 22.8 and 30.7 months, respectively, which clearly exceeds the same indicators when using standard methods of anticancer chemotherapy. The method of electrochemotherapy using Scandinavian ChemoTech AB equipment has already been registered in Ukraine and will soon improve the treatment of patients with complex tumors of various localizations, including those with unresectable forms of pancreatic cancer.