Expert Point of View: Charles E. Ray, Jr, MD, PhD

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Addressing the studies on cryoablation and irreversible electroporation ablation at a Society of Interventional Radiology press briefing, Charles E. Ray, Jr, MD, PhD, Chief of Interventional Radiology at University of Colorado, told The ASCO Post that these novel approaches to metastases are interesting, but noted that there have been obstacles to their adoption.

“Cryoablation predates everything else” in the field of ablation therapy, he noted. “Back when this was an open procedure, surgeons used a 24 French device, which is huge. Now we use a 17-gauge probe, which makes a big difference. But because of the concerns of 20 years ago, such as liver fractures from using such large devices, people are still nervous about cryoablation,” he said.

“As for irreversible electroporation,” he continued, “you can ask why this [approach] hasn’t taken off. It’s probably because it is challenging. You need two electrodes, perfectly placed. There’s a learning curve.”

In both studies, he added, it is difficult to separate out the effects of the intervention from the effects of the chemotherapy. Most patients were receiving systemic treatment before and after these procedures. ■

Disclosure: Dr. Ray reported no potential conflicts of interest.

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