IMage-guided Pancreatic Ablation for Cancer Therapy (IMPACT) (360G-Wellcome-201080_Z_16_Z)

Pancreatic cancer is a biologically aggressive cancer, which is resistant to chemotherapy and radiotherapy and has a high rate of recurrence. Surgical resection remains the only treatment with potential for long-term survival and cure. However, many patients have metastatic disease at presentation and a third have locally advanced pancreatic cancer, leaving only 10% - 20% suitable for potentially curative resection. Even after resection, recurrence is common and adjuvant chemotherapy is used but thermal ablation, which is established for palliation of other cancers, is not recommended for unresectable pancreatic cancer because of risk of injury to the pancreatic duct or nearby major blood vessels. This project will develop a patient-specific planning, simulation and intra-operative navigation system for individualised ablation and palliation of inoperable pancreatic cancer. We will investigate a new technique – irreversible electroporation ablation (IRE) – which causes cell death through a different mechanism to thermal ablation that can minimise damage to the pancreatic duct and major blood vessels. We will develop a navigation system so that accurate IRE electrode placement can be carried out percutaneously or under laparoscopic guidance. The potential impact of the project will be to prolong and increase the quality of life for a patient population with limited treatment options.