This site became the new on June 19th. Learn more.
Show more Menu IMPORTANT: Listing of a study on this site does not reflect endorsement by the National Institutes of Health. Talk with a trusted healthcare professional before volunteering for a study. Read more... Menu IMPORTANT: Talk with a trusted healthcare professional before volunteering for a study. Read more... Menu
Give us feedback

PANFIRE Study: Irreversible Electroporation (IRE) to Treat Locally Advanced Pancreatic Carcinoma (PANFIRE)

This study is currently recruiting participants.
See Contacts and Locations
Verified April 2016 by Dr. M.R. Meijerink, VU University Medical Center
Information provided by (Responsible Party):
Dr. M.R. Meijerink, VU University Medical Center Identifier:
First received: September 3, 2013
Last updated: April 28, 2016
Last verified: April 2016

Irreversible electroporation (IRE) is a new, minimal-invasive image-guided treatment method for tumors not amenable for surgical resection or thermal ablation, due to vicinity near vital structures such as vessels and bile ducts. With IRE, multiple electrical pulses are applied to tumorous tissue. These pulses alter the existing transmembrane potential of the cell membranes, and create 'nanopores', after which the cell dies through loss of homeostasis.

The purpose of this study is to investigate the safety of percutaneous IRE in the treatment of patients with locally advanced pancreatic carcinoma (LAPC). Other objectives are feasibility and efficacy of IRE based upon symptomatic response and tumor response.

Fourty patients with histologically confirmed locally advanced pancreatic adenocarcinoma (<5cm) will undergo percutaneous irreversible electroporation of the tumor using CT and ultrasound guidance. After IRE, patients will be carefully monitored and any (serious) adverse events are registered. Follow-up will consist of frequent CT scanning, as well as serum CA19.9 tumor marker.

We hypothesize that IRE in the pancreas will induce good symptom palliation and local tumor control, without causing severe complications.

Condition Intervention Phase
Locally Advanced Pancreatic Carcinoma (LAPC) Non-metastasized Unresectable Pancreatic Carcinoma Pancreatic Cancer Device: NanoKnife "Irreversible electroporation (IRE)" Phase 1 Phase 2

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: PANFIRE - Pilot-study: Non-thermal Ablation Using Irreversible Electroporation (IRE) to Treat Locally Advanced Pancreatic Carcinoma - a Phase I Clinical Trial

Resource links provided by NLM:

Further study details as provided by Dr. M.R. Meijerink, VU University Medical Center:

Primary Outcome Measures:
  • Safety (number of adverse events) [ Time Frame: early: 90 days; late: 12 months ]
    Number of adverse events of IRE-treatment (within 12 months after treatment) are registered and analyzed according to the CTCAE version 4.0. Complications related to IRE are early complications during hospital admission (e.g. bile leak, bowel leak, infection, pancreatitis), or late complications of IRE such as bile duct stenosis that become apparent during follow-up in the year after treatment.

Secondary Outcome Measures:
  • Tumor response [ Time Frame: 12 months ]
    • Ablation success: the ability to deliver the planned therapy and at 3 months to have no evidence of residual tumor;
    • Local recurrence rate (LRR): defined as the reappearance of viable tumor after a period of time during which viable tumor could not be detected;
    • Overall survival and (local and distant) progression-free survival.

Estimated Enrollment: 40
Study Start Date: September 2013
Estimated Study Completion Date: October 2016
Estimated Primary Completion Date: October 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Irreversible electroporation
Single arm study: Percutaneous irreversible electroporation of locally advanced pancreatic carcinoma
Device: NanoKnife "Irreversible electroporation (IRE)"
Tumor ablation with irreversible electroporation with the NanoKnife
Other Names:
  • IRE
  • NanoKnife


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

Screening must be performed no longer than 2 weeks prior to study inclusion.

  • Radiologic confirmation of LAPC by at least ceCT of chest and abdomen (with the upper abdomen scanned according to a dedicated 3mm slice multiphase pancreatic tumor protocol), performed maximum 2 weeks prior to the procedure;
  • Maximum tumor diameter ≤ 5 cm;
  • Histological or cytological confirmation of pancreatic adenocarcinoma;
  • Age ≥ 18 years;
  • ASA-classification 0 - 3
  • Life expectancy of at least 12 weeks;
  • Adequate bone marrow, liver and renal function as assessed by the following laboratory requirements to be conducted within 7 days prior to definite inclusion;

    • Hemoglobin ≥ 5.6 mmol/L;
    • Absolute neutrophil count (ANC) ≥ 1,500/mm3;
    • Platelet count ≥ 100*109/l;
    • Total bilirubin ≤ 1.5 times the upper limit of normal (ULN);
    • ALT and AST ≤ 2.5 x ULN;
    • Serum creatinine ≤ 1.5 x ULN or a calculated creatinine clearance ≥ 50 ml/min;
    • Prothrombin time or INR < 1.5 x ULN;
    • Activated partial thromboplastin time < 1.25 x ULN (therapeutic anticoagulation therapy is allowed if this treatment can be interrupted as judged by the treating physician);
  • Written informed consent;

Exclusion Criteria:

  • Resectable pancreatic adenocarcinoma as discussed by our multidisciplinary hepatobiliary team;
  • Extrapancreatic metastases;
  • Successful down staging after (radio)chemotherapy from previous unresectable/borderline tumor to resectable tumor;
  • Stage IV pancreatic carcinoma;
  • History of epilepsy;
  • History of cardiac disease:

    • Congestive heart failure >NYHA class 2;
    • Active Coronary Artery Disease (defined as myocardial infarction within 6 months prior to screening);
    • Cardiac arrhythmias requiring anti-arrhythmic therapy or pacemaker (beta blockers for antihypertensive regimen are permitted);
  • Uncontrolled hypertension. Blood pressure must be ≤160/95 mmHg at the time of screening on a stable antihypertensive regimen;
  • Compromised liver function (e.g. signs of portal hypertension, INR > 1,5 without use of anticoagulants, ascites);
  • Uncontrolled infections (> grade 2 NCI-CTC version 3.0);
  • Pregnant or breast-feeding subjects. Women of childbearing potential must have a negative pregnancy test performed within 7 days of the start of treatment;
  • Immunotherapy ≤ 6 weeks prior to the procedure;
  • Chemotherapy ≤ 6 weeks prior to the procedure;
  • Radiotherapy ≤ 6 weeks prior to the procedure;
  • Concomitant use of anti-convulsive and anti-arrhythmic drugs (other than beta blockers used for antihypertensive);
  • Allergy to contrast media;
  • Any implanted stimulation device;
  • Any implanted metal stent/device within the area of ablation that cannot be removed;
  • Any condition that is unstable or that could jeopardize the safety of the subject and their compliance in the study;

Of note, patients with contra-indications for MRI will not be excluded from participation: in this case radiologic follow-up will consist of CT-scanning according to protocol.

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01939665

Contact: Laurien GPH Vroomen, MD +31204440347
Contact: Martijn R Meijerink, MD, PhD +31204444444

VU University Medical Center Recruiting
Amsterdam, Noord-Holland, Netherlands, 1081 HV
Contact: Laurien GPH Vroomen, MD    +31204440347   
Contact: Martijn R Meijerink, MD, PhD    +31204444444   
Principal Investigator: Geert Kazemier, Prof. Dr.         
Principal Investigator: Martijn R Meijerink, MD, PhD         
Sponsors and Collaborators
VU University Medical Center
Principal Investigator: Martijn R Meijerink, MD, PhD VU University Medical Center, Department of Radiology and Nuclear Medicine
Principal Investigator: Geert Kazemier, Prof. Dr. VU University Medical Center, Department of Surgery
Study Director: Cornelis van Kuijk, Prof. Dr. VU University Medical Center, Head of Department of Radiology,
  More Information

Responsible Party: Dr. M.R. Meijerink, Dr., VU University Medical Center Identifier: NCT01939665     History of Changes
Other Study ID Numbers: NL42888.029.13
2013/155 ( Registry Identifier: 2013/155 )
Study First Received: September 3, 2013
Last Updated: April 28, 2016

Keywords provided by Dr. M.R. Meijerink, VU University Medical Center:
Locally advanced pancreatic carcinoma
Irreversible electroporation
Non-thermal ablation
Percutaneous ablation
Low Energy Direct Current

Additional relevant MeSH terms:
Pancreatic Neoplasms
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Digestive System Neoplasms
Neoplasms by Site
Endocrine Gland Neoplasms
Digestive System Diseases
Pancreatic Diseases
Endocrine System Diseases processed this record on August 16, 2017