Ultrasound sonoporation in pancreatic adenocarcinoma

International audience; ObjectivesThe objectives of this Phase I study were to investigate the safety and the ability of inducing sonoporation in a clinical setting, using commercially available technology, to increase the patients’ quality of life and to possibly increase the overall survival in patients with pancreatic adenocarcinoma.Methods10 Patients were treated using a customized configuration of a commercial clinical ultrasound scanner (GE LOGIQ 9) over a time period of 31.5 min following standard chemotherapy treatment with gemcitabine. SonoVue was injected intravenously during the treatment with the aim of inducing sonoporation. To ensure microbubbles were present throughout the whole treatment, 0.5 ml of contrast agent followed by 5 ml saline were injected every 3.5 min, i.e., at T = 30.0, 33.5, 37.0, 40.5, 44.0, 47.5, 51.0, 54.5, and 58.0min. A single vial (4.5 ml) was used throughout each treatment. Treatment was stopped at T=61.5 min. The total cumulated ultrasound treatment time was only 18.9 s. Gemcitabine was administered by intravenous infusion at a dose of 1000 mg/m2 over 30 min.ResultsUsing the authors’ custom acoustic settings, the 10 patients were able to undergo an increased number of treatment cycles; from an average of 8 cycles, to an average of 14 cycles when comparing to a historical control group of 80 patients. In the first two out of five patients treated (published data, ref below), the maximum tumor diameter was temporally decreased to 80 ± 5% and permanently to 70 ± 5% of their original size, while the other patients showed reduced growth. Compared to historical data, there was increased survival with 60% of patients surviving 12 months (versus 10% in literature).ConclusionsIt is possible to combine ultrasound, microbubbles, and chemotherapy in a clinical setting using commercially available clinical ultrasound scanners to increase the number of treatment cycles. Our study also indicates increased survival in patients with inoperable pancreatic adenocarcinoma. Ref: Medical Physics, Vol. 40, No. 7, July 2013.