Using pulsed electric field ablation for resectable tumors helps not only kill the cancerous cells but might reinvigorate a patient’s immune system to fight back against their cancers.
Thoracic surgeon K. Patrick Sesastadt, MD, MBA, FACS, and Michael Petroziello, MD, Director of Interventional Radiology , both at Roswell Park Comprehensive Cancer Center, discuss their uses of the Aliya system, a pulsed electric field ablation tool that uses a non-thermal approach to cause a “more natural cell death.” A less-invasive procedure that can be done during a biopsy and applied either bronchoscopically or through the skin means patients also have a faster recovery from the procedure and are usually home the same day.
I, I am, uh, Pat Systead. I'm one of the thoracic surgeons here at Roswell Park Comprehensive Cancer Center. Today we'll be talking about the AI technology. The Eliah system is a new ablation technology. It works in a different way from traditional ablation technologies and the fact that it's nonthermal, so it works through electrical fields. Where it disturbs the electrical cell membrane and causes more of a natural cell death as opposed to a thermal destructive type of cell death and that we believe releases more immune stimulating molecules that would allow the immune system to recognize some of the antigens related to the tumors. You can do multiple we call them activations uh on the same tumor or you could target different tumors in the same patient. Um, this is typically done under general anesthesia, but, um, most patients will go home the same day after this procedure. So in terms of the types of cancers, Alia can be used for, it really can be used for any cancer. It's FDA approved, so this is not an experimental technology. Uh, it's really approved for any lesion that we believe we can ablate. There's some trials coming out using it even in resectable disease where. Uh, a patient, let's say it's a concern for an early lung cancer, they get their biopsy, whether that's with IR through transthoracic biopsy or with us on the thoracic surgery or interventional pulmonology side with a navigational bronchoscopic biopsy. Let's say it comes back, it's a 2 centimeter tumor comes back positive for cancer through that same needle, you can thread the catheter of the Aa device and treat that tumor at the same time and then move on to resection. As planned or or whatever neoadjuvant treatment that patient would need, so there are paradigm shifts for using this in the resectable early stage patients in addition to these patients with very advanced disease as well just given how safe it is and it doesn't affect the surgeries we have to do later. We were the first to acquire this technology in western New York. Um, it is at most major medical institutions throughout the country. Um, but we were the first to use it here in Western New York, and we certainly have the highest volume in western New York, uh, for this type of procedure. Also some of the other thoracic surgeons that are doing this are Doctor Mark Hannon, Doctor Elizabeth Dexter, and our interventional pulmonologist Doctor Ivanic, uh, can also do this as well, and our interventional radiology team are excellent, and Doctor, uh, Mike Petrus Zielo is, uh, leading that charge. Hi, I'm Doctor Michael Petriella, director of interventional radiology here at Roswell Park Comprehensive Cancer Center. There are two ways, uh, to apply this, uh, ablation technique. One is bronchoscopically with our thoracic colleagues. The other is percutaneously through the skin where interventional radiology comes into play. So we use CAT scan or ultrasound guidance to direct the needle accurately into the tumor and apply the energy. The patient is completely sedated under anesthesia, so they will not feel anything that we're doing. Uh, it takes roughly about an hour to perform depending on the size of the tumor. Recovery is here with us for a few hours and then the patient gets discharged home the same day. Given this is percutaneously through the skin, it's a noninvasive procedure. Uh, the recovery time is, uh, fast, and that's why we can offer this as an outpatient procedure. Uh, no major incisions. Recovery time is uh about a week of just mild soreness at the site. Otherwise patients can continue their normal activities of daily living. Traditionally we've used thermal energy, uh, which is cryoablation where we freeze the tumor or microwave ablation where we're generating high heat to kill the tumor. Uh, pulse electrical field while the dead is still coming in, uh, is shown to be very effective in killing both the local tumor and then hopefully generating that systemic anti-tumor response to target other tumors throughout the body. So ideal candidates for this therapy fall into two categories. The first is a patient who has a tumor near an important structure that we want to offer ablation to. And given that this is a nonthermal energy, it is much safer in that regard, uh, would reduce risk for injuring those important structures. The other category is patients who are progressing, uh, with metastatic disease through one or two lines of therapy, and the idea being when we use this technology, we can create a systemic, uh, immune response that could potentially act locally and throughout the body. So Lea is a relatively new technology. We are one of the first in the region to offer it. It has been developed for a few years at other centers, so we're starting to accumulate more and more data, uh, still waiting for that data to come in, and we're happy to be a part of that. If you have a patient who you think may be a good candidate for a Le Pulse electrical field, feel free to reach out to us at Roswell Park, and we can work together to create an effective treatment plan for your patient.
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