Anyone knows about this? Electrochemotherapy The new alternative to radiation therapy for prostate cancer recurrence and metastates.

[Soumen79]

Lot of advertising in the site, but anyone here has any info about this?

vitusprostate.com/en/electr...

[GP24]

This is about the only clinic which offers this therapy. No trials with a control group to test the efficacy available yet.

[Tall_Allen]

Here are some articles about IRE aimed at the prostate (not metastases):

prostatecancer.news/2016/08...

prostatecancerinfolink.net/...

prostatecancer.news/2016/08...

prostatecancer.news/2017/09...

I think it is an interesting technique when used against metastases at lower currents for reversible electroporation. It "opens up" tumor cells to allow types of chemo that are normally ineffective in prostate cancer to flow into the cells. It can be used in places where radiation cannot be safely delivered.

[Soumen79 in reply to Tall_Allen]

Nice to know that you are on positive side. Will check the links, thank you TA!!

[cesces in reply to Soumen79]

"This is about the only clinic which offers this therapy. No trials with a control group to test the efficacy available yet."

Not a good sign

That Tall_Allen seems potential is a good sign.

But that he conditions his qualified assessment to non-metastatic prostate cancer.

It seems to be a promising treatment. Maybe not quite ready for prime time, unless it has some particular case specific benefit to your specific situation.... which seems unlikely in the case of non- metastatic prostate cancer.

[Hombre in reply to cesces]

I believe the Royal Free Hospital in London, UK, is the lead for this type of treatment, initially for skin cancers

[GabF in reply to cesces]

IRE (irreversible) is used in a French multicentric trial of 260 patients, ending in 2024. This trial is about using mpMRI as a follow-up tool after focal therapy. One of the focal therapy is IRE. The trial is named IRMProft (IRM=MRI)

clinicaltrials.gov/ct2/show...

[FRTHBST]

I had an IRE treatment at Vitus. Pathology indicated Gleason 7 , 4+3, revised by M.D. Anderson to 9, large tumor volume with epe, possible local spread. They did reversible electroporation and simultaneous treatment with cancer drug. PSA went from 30 to 3 within 3 months, then climbed again. For me with a nearly whole gland ablation it was not definitive. I did a lot of research before deciding to take that route and I think with a smaller volume metastasis, it could be more effective. Another consideration is the lack of damage to surrounding tissue, so it can be repeated. It was expensive though and that definitely figured into not seeking another round. Also, Vitus was not good at answering follow up questions. I think MSK has been using IRE on some types of cancer.

[Soumen79 in reply to FRTHBST]

Thank you FRTHBST, nice to get first hand experience, I hope you are doing fine now.

[lokibear0803]

The use of IRE when it introduces a chemo agent into cells might have some legs, as TA suggests. I would agree with TA that the reversible process is interesting and I’d add that it might be preferable, if we expect to see adjacent-cell effects.

Pls note that TA’s articles discuss various caveats, limitations and side effects — as opposed to the claims made on (at least one page of) the Vitus site about sparing all tissue except the cancer cells. If one is seriously considering using IRE, I’d strongly recommend reading TA’s articles. You might first read this one:

prostatecancer.news/2017/09...

…where in a small trial it was reported that:

Incontinence requiring pads was suffered by 27% … Potency preservation was reported by 33% (2 of 6 patients)

Regarding side effects, I’ve so far only read this page from the Science section at Vitus:

vitusprostate.com/en/scienc...

I do realize that this page discusses a technique that’s different from IRE per se, but I was interested in reading multiple articles to get a sense of Vitus’ overall credibility. I’ll comment on a few specifics, in particular around sparing surrounding tissue beyond the tumor:

But important anatomical structures in and around the prostate such as nerves, the intestinal wall, the sphincter, veins and arteries are spared. Erection and bladder control are thus spared.

That would be fantastic if it’s true. How exactly are they succeeding? Again, from that Vitus page:

Tissue selectivity: Only cells, which have a cell membrane—such as cancer cells—are reliably destroyed, while all other structures (nerves, arteries, connective tissue structures, etc.) remain unharmed.

This last sentence is a bit ambiguous due to the comma after the opening phrase…are they saying that, yes, of course, all cells have cell membranes but (somehow) only cancer cells are destroyed? If so, they still haven’t explained how cancer cells are isolated as a target.

If however they’re stating that only cancer cells have membranes, this is nonsense. All eukaryotic (e.g. human) cells have cell membranes. At this point, assuming either weak copywriting or misinformation, I stopped reading the Vitus articles.

[Soumen79 in reply to lokibear0803]

Very good analysis, thank you sir!

[FRTHBST in reply to lokibear0803]

In my experience, urethra and nerves did not seem to be dramatically affected and i did not experience incontinence. I agree that the language of tissue selectivity seems vague. In my case with the reversible electroporation I think that the cancer cells would sustain the most damage as the cancer drug used, bleomycin, has a greater affinity for cancer cells. Not sure if the mechanism is understood. The possibility of "bystander effects" similar to what's observed with radiation may also be present after IRE, but less of an issue (both positive and negative with reversible electroporation) ncbi.nlm.nih.gov/pmc/articl..., so that observation of less effects on adjacent cells seems to hold.