Pancreatic cancer is the fourth leading cause of cancer deaths in the country, and one of the most difficult of the solid tumors to treat. Wolf E. Heberlein, MD, assistant professor of radiology, University of Arkansas for Medical Sciences (UAMS), is hopeful that his current research will result in a technique to break the stroma around the tumor so it can be penetrated with anti-cancer drugs combined with short bursts of high voltage electricity. Heberlein has received a two-year, $150,000 Research Scholar Grant from the Radiological Society of North America (RSNA) Research and Education (R&E) Foundation for the research aimed at overcoming the current surgical and drug barriers for treating pancreatic cancer by using a minimally invasive, image-guided approach with electric probes.“Dr. Heberlein's project will investigate a highly innovative and potentially effective way to treat a disease that, at present, is almost universally fatal,” said Hedvig Hricak, MD, PhD, a member of the R&E Foundation Board of Trustees and past president of the RSNA. “It exemplifies the kind of creative, clinically relevant research that the R&E Foundation was designed to support.”Heberlein picked pancreatic cancer because it is the most challenging of the solid tumors. “If it works with pancreatic cancer, I don’t see why it wouldn’t work with other solid tumor cancers,” he said. Heberlein’s translational research work entails using laboratory studies to optimize and find new ways to improve drug penetration into pancreatic cancer by improving technology already in clinical use, Irreversible Electroporation (IRE). IRE uses very short, high-voltage impulses to selectively facilitate drug penetration. Heiberlein said better drug penetration and high-voltage impulses should kill the tumor cells more reliably while reducing side effects. “The technology is in use to treat certain tumors with a NanoKnife, needles and probes, and to treat disease with electrical impulses,” he said. “We are trying to take that as a platform and build on it to improve that technology by optimizing the electricity impulses to get the drugs where they belong, into the pancreatic cancer.” Heberlein has already had e-mails from pancreatic patients wanting to try the new treatment, but the technique is not yet ready for clinical trials. “Nothing is ready to roll right now,” he said. “Everyone wants it right now. A couple years down the road it should be ready for clinical trials. It is using an established technology, but putting these modules together in a new way. It puts things together in a foreseeable manner to have success.” If it is successful with pancreatic cancer, there is hope for its use in other cancers, like a subgroup of breast cancers that have a stroma around the tumors. The dense structure protects the cancer from conventional drug delivery like chemotherapy. “That is why most of traditional pharmacology doesn’t work because it doesn’t see the cancer,” Heberlein said. “Stroma is a like a cocoon. So we try to break through that cocoon. The main thing is the use of a special application of electricity percutaneously. It is minimally invasive. We use image guidance to place the needles where they are needed to deliver a combination of drugs and electrical treatment, and whatever else we come up with.”One advantage of this is that it is a platform, not a one-shot application. Heberlein said with that platform, you could apply a number of different things: conventional drugs, new drugs, and nanoparticles. “We have the Center for Integrative Nanotechnology Sciences at the University of Arkansas Little Rock,” Heberlein said. “These very small particles are the dream right now for everyone. They can go everywhere because they are so small. They can induce a changed environment. They could make radiotherapy efficient. You can also incite more oxygen to make radiotherapy more efficient.”Heberlein’s grant proposal was developed under the mentorship of Michael Borrelli, PhD, professor of radiology and biophysics at the University of Arkansas for Medical Sciences (UAMS) College of Medicine and associate director of the Arkansas Nanomedicine Center. Peter Crooks, PhD, chair of the UAMS College of Pharmacy Department of Pharmaceutical Sciences, also will serve as Heberlein's mentor.
