GRANTEE: David Iannitti, MD
Carolinas Medical Center
Co-Principal Investigator: Rafael Davalos, PhD, Virginia Polytechnic Institute and State University
Research Project: Developing Next Generation IRE to Treat Pancreatic Cancer
Award: 2016 Pancreatic Cancer Action Network Translational Research Grant
Award Period: July 1, 2016 – June 30, 2018
Dr. Iannitti is a board-certified surgeon with a specialty in hepato-pancreato-biliary (HPB) surgery. Academically, he is the chief of HPB surgery and program director for the HPB Fellowship Program at Carolinas Medical Center. He also holds adjunct professorships in surgery (University of North Carolina [UNC]-Chapel Hill) and biology (UNC-Charlotte). Dr. Iannitti received a bachelor’s degree, certificate of completion and medical doctorate at Tufts University, Dartmouth Medical School and Brown University Medical School, respectively.
Dr. Davalos joined the faculty of Virginia Tech – Wake Forest University in 2006 as an assistant professor. He is currently a professor and faculty fellow of engineering. He did his undergraduate studies at Cornell University and received a master’s degree in mechanical engineering and a PhD in bioengineering from University of California, Berkeley. Dr. Davalos is the lead inventor of two technologies aimed to treat cancer locally, known as irreversible electroporation (IRE) and high frequency irreversible electroporation (H-FIRE). His laboratory conducts fundamental research to develop innovative methods for detecting and treating cancer.
Conventional treatment options for pancreatic cancer (and other solid tumors) include surgery, chemotherapy and radiation. Whereas surgery offers the best chance for long-term survival, fewer than 20 percent of pancreatic cancer patients are eligible for surgery at diagnosis. An alternative to surgical resection is a process known as tumor ablation, a minimally invasive treatment that utilizes thermal energy (heat) or electrical pulses to destroy the cancer cells.
Thermal ablation nonspecifically destroys tissue surrounding the tumor, including blood vessels and normal structural cells. By contrast, electrical pulses through irreversible electroporation (IRE) selectively damage cancer cells. IRE functions by poking holes in the membrane of cancer cells, which causes the cells to undergo apoptosis, or programmed cell death (also known as cellular suicide). Existing IRE technology (NanoKnife®) requires several electrodes to be placed around the tumor, followed by repeat electrical pulsing that is synchronized with the patient’s heartbeat. Insertion of the electrodes is extremely complex – especially in an anatomically challenging site like the pancreas.
Here, Drs. Iannitti and Davalos will investigate the utility of a new system capable of delivering high-frequency IRE, called H-FIRE. Whereas standard IRE can require up to 90 minutes for electrode placement and 60 to 90 minutes for administration of the electrical pulses, the set-up for H-FIRE is simpler because it does not need to synchronize with the patient’s heartbeat, and the treatment itself only takes 10 minutes. Drs. Iannitti and Davalos and their research teams therefore propose to evaluate the ability of H-FIRE to kill pancreatic cancer cells and spare normal tissue in a large animal model (pigs). They will also calibrate the effectiveness of the procedure using human tissue samples. Completion of these studies will provide critical data supporting the viability of H-FIRE to treat pancreatic cancer. The advance of this technology toward patient use is strengthened by the experience of the investigative team and their background in developing and implementing ablation technology.