High-voltage electrical pulses (HVEPs) are being used as a non-heat-based treatment for pancreatic cancer. HVEPs work by applying strong electric fields that create tiny pores in cancer cell membranes, a process called electroporation. Lower electric fields temporarily increase cell permeability and make tumors more sensitive to drugs, while stronger fields cause permanent damage that leads to cancer cell death. These pulses also disrupt internal cell processes, such as calcium balance and energy production, triggering multiple forms of cell death.
Beyond directly killing cancer cells, HVEPs can stimulate the immune system. Pancreatic cancer is usually resistant to immune attack, but HVEP treatment causes cancer cells to release danger signals that alert immune cells. This activates dendritic cells and cancer-killing T cells, shifts cytokines toward an anti-tumor profile, and improves blood flow and oxygen levels in the tumor without destroying nearby blood vessels. As a result, the tumor environment becomes more responsive to immune-based therapies.
Clinically, irreversible electroporation (IRE), often known as NanoKnife, is the most common HVEP technique used today. It is mainly applied in locally advanced pancreatic cancer that cannot be surgically removed and has been shown to improve survival compared with chemotherapy alone. The procedure can be done through minimally invasive approaches and is relatively safe for critical structures like blood vessels and bile ducts. Because the immune effects are temporary, HVEPs are increasingly being combined with chemotherapy, immunotherapy, and nanotechnology-based drug delivery to enhance and prolong treatment benefits.