{"entity":{"id":"irreversible-electroporation","kind":"technology","name":"Irreversible electroporation (NanoKnife)","aka":[],"tldr":"Irreversible electroporation uses short high-voltage pulses that punch permanent holes in tumour cells while sparing nearby vessels and ducts.","summary":"Irreversible electroporation delivers microsecond high-voltage pulses between needle electrodes, permanently disrupting cell membranes while leaving collagenous structures such as vessels and ducts intact. This non-thermal mechanism is why it is used in locally advanced pancreatic cancer wrapped around vessels, where heat-based ablation would be unsafe, and in focal prostate therapy (FDA 2024 for prostate). The procedure requires general anaesthesia with muscle paralysis and cardiac synchronisation, because the pulses can trigger contractions and arrhythmia. Randomised data remain limited, so its survival benefit in pancreatic cancer is not yet established. The simple version is that electrical pulses punch permanent holes in tumour cells while sparing the pipes running through them.","status":"established","asOf":"2026-09-04","wikipedia":"https://en.wikipedia.org/wiki/Irreversible_electroporation","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Irreversible_electroporation"}],"tags":[],"related":[],"cancers":["pancreatic","prostate"],"sections":["surgery","devices"],"technologies":[],"targets":[],"drugs":[],"companies":["angiodynamics"],"institutions":[],"pathways":[],"terms":[],"trials":["nct03899636"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"Microsecond electrical pulses between needle electrodes disrupt membranes irreversibly.","strengths":["Safe next to vessels and bile ducts"],"limitations":["General anaesthesia with paralysis; cardiac synchronisation","Limited randomised data"]},"route":"/technologies/irreversible-electroporation/","neighbours":{"cancer":[{"id":"locally-advanced-pdac","kind":"cancer","name":"Locally advanced unresectable pancreatic ductal adenocarcinoma","route":"/cancers/locally-advanced-pdac/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"section":[{"id":"devices","kind":"section","name":"Devices & Physical Therapies","route":"/fronts/devices/"},{"id":"surgery","kind":"section","name":"Surgery & Interventional","route":"/fronts/surgery/"}],"company":[{"id":"angiodynamics","kind":"company","name":"AngioDynamics","route":"/companies/angiodynamics/"},{"id":"igea","kind":"company","name":"IGEA","route":"/companies/igea/"}],"trial":[{"id":"nct03899636","kind":"trial","name":"A Pivotal Study of Safety and Effectiveness of NanoKnife IRE for Stage 3 Pancreatic Cancer","route":"/trials/nct03899636/"},{"id":"nct06938503","kind":"trial","name":"AG Plus Nimotuzumab Sequential Irreversible Electroporation Ablation for Locally Advanced Pancreatic Cancer","route":"/trials/nct06938503/"},{"id":"crossfire","kind":"trial","name":"CROSSFIRE","route":"/trials/crossfire/"},{"id":"nct07306273","kind":"trial","name":"IRE Combined With the Dual-Function Antibody PD-1/CTLA-4 for the Treatment of LAPC Following Failure of First-Line AG Therapy","route":"/trials/nct07306273/"},{"id":"panfire-2","kind":"trial","name":"PANFIRE-2","route":"/trials/panfire-2/"}],"technology":[{"id":"cryoablation-systems","kind":"technology","name":"Cryoablation systems","route":"/technologies/cryoablation-systems/"},{"id":"electrochemotherapy","kind":"technology","name":"Electrochemotherapy","route":"/technologies/electrochemotherapy/"},{"id":"electrochemotherapy-devices","kind":"technology","name":"Electrochemotherapy devices (Cliniporator)","route":"/technologies/electrochemotherapy-devices/"},{"id":"il12-electroporation","kind":"technology","name":"Intratumoural gene electrotransfer (IL-12 plasmid)","route":"/technologies/il12-electroporation/"},{"id":"microwave-rf-ablation","kind":"technology","name":"Microwave and radiofrequency ablation systems","route":"/technologies/microwave-rf-ablation/"}],"idea":[{"id":"idea-fund-ablation-versus-surgery-trials","kind":"idea","name":"Device-agnostic public trials of ablation technologies against surgery","route":"/ideas/idea-fund-ablation-versus-surgery-trials/"},{"id":"idea-bio2-histotripsy-immune-priming","kind":"idea","name":"Mechanically pulverise one tumour with ultrasound to wake the immune system","route":"/ideas/idea-bio2-histotripsy-immune-priming/"}],"institution":[{"id":"onkoloski-institut-ljubljana","kind":"institution","name":"Institute of Oncology Ljubljana","route":"/institutions/onkoloski-institut-ljubljana/"}],"roadmap":[{"id":"devices-roadmap","kind":"roadmap","name":"Devices and physical therapies roadmap: heat and light → electric fields and focused sound → drug-releasing implants","route":"/roadmaps/devices-roadmap/"},{"id":"surgery-roadmap","kind":"roadmap","name":"Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work","route":"/roadmaps/surgery-roadmap/"}]}}