{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T05:10:59Z","timestamp":1760764259588,"version":"build-2065373602"},"reference-count":61,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001665","name":"French National Research Agency","doi-asserted-by":"crossref","award":["ANR-10\u2013IAHU-02"],"award-info":[{"award-number":["ANR-10\u2013IAHU-02"]}],"id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Ontario Ministry of Economic Development and Trade","award":["ORF 08-022"],"award-info":[{"award-number":["ORF 08-022"]}]},{"DOI":"10.13039\/100009812","name":"Princess Margaret Cancer Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100009812","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Pancreatic cancers can involve large blood vessels early, making complete resection technically challenging or impossible. A minimally invasive treatment that clears vessels from encasing tumours could potentially enable curative surgery. We hypothesise that Endovascular Photo-activated Ablation (EPA) of perivascular tumour tissue can create a necrotic zone free of viable tumour between cancer and blood vessels, through which the tumour could be resected. Methods: A dose escalation study was conducted in the normal porcine model (n = 7). Under general anaesthesia, the animals were given a photo-activated drug and photo-activation was provided by a prototype balloon catheter, positioned in a major blood vessel within the pancreas, under angiographic guidance. Contrast-enhanced CT scans were undertaken prior to and 1, 2, or 7 days following ablation. The animals were euthanised and the exposed tissue excised en bloc for histological examination. Results: Five animals were euthanised after 2 days. On post-mortem, the histology confirmed necrotic pancreas in the perivascular zone, which increased from zero to 15 mm around the treated vessel, for increasing drug doses. Treated arteries showed necrotising arteritis, without evidence of perforation or obstruction during the observation period, although one animal was euthanised at 1 day, due to technical endovascular device issues and obstruction. The lowest-dose animal euthanised at 7 days showed no lesions on pathology. Conclusions: These proof-of-concept results demonstrate that EPA can produce pancreatic perivascular necrosis in a large animal model. In a pancreatic cancer abutting a major blood vessel, this procedure may be able to create a zone free of viable tumour, potentially rendering these cancers operable, while preserving vessel integrity. These findings support further research activities towards clinical translation.<\/jats:p>","DOI":"10.3390\/cancers17203340","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T16:33:22Z","timestamp":1760632402000},"page":"3340","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring Endovascular Photo-Activated Ablation (EPA) for Downstaging Locally Advanced Pancreatic Cancer: A Proof-of-Concept Study in the Normal Porcine Model"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5859-2852","authenticated-orcid":false,"given":"Alain","family":"Garc\u00eda V\u00e1zquez","sequence":"first","affiliation":[{"name":"IHU Strasbourg, Institute for Image-Guided Surgery, 67091 Strasbourg, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9127-8467","authenticated-orcid":false,"given":"Juan Manuel","family":"Verde","sequence":"additional","affiliation":[{"name":"IHU Strasbourg, Institute for Image-Guided Surgery, 67091 Strasbourg, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fan\u00e9lie","family":"Wanert","sequence":"additional","affiliation":[{"name":"IHU Strasbourg, Institute for Image-Guided Surgery, 67091 Strasbourg, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene Alexandra","family":"Spiridon","sequence":"additional","affiliation":[{"name":"IHU Strasbourg, Institute for Image-Guided Surgery, 67091 Strasbourg, France"},{"name":"Department of Pathology, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Axel","family":"Schmid","sequence":"additional","affiliation":[{"name":"Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tina","family":"Saeidi","sequence":"additional","affiliation":[{"name":"Department of Medical Biophysics, University of Toronto, Toronto, ON M5G1L7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee L.","family":"Swanstrom","sequence":"additional","affiliation":[{"name":"IHU Strasbourg, Institute for Image-Guided Surgery, 67091 Strasbourg, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5538-9303","authenticated-orcid":false,"given":"Stephen G.","family":"Bown","sequence":"additional","affiliation":[{"name":"Research Department of Targeted Intervention, Division of Surgery and Interventional Science, University College London, London W1W 7TY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5533-0005","authenticated-orcid":false,"given":"Lothar","family":"Lilge","sequence":"additional","affiliation":[{"name":"Department of Medical Biophysics, University of Toronto, Toronto, ON M5G1L7, Canada"},{"name":"Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G1L7, Canada"},{"name":"Faculty of Health Science, Laser Research Centre, University of Johannesburg, Doornfontein, Johannesburg P.O. Box 17011, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arjen","family":"Bogaards","sequence":"additional","affiliation":[{"name":"Vascular Oncology Biotechnologies B.V., 6525 EC Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"ref_1","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA A Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1002\/bjs.9716","article-title":"Molenaar. Systematic review of innovative ablative therapies for the treatment of locally advanced pancreatic cancer","volume":"102","author":"Rombouts","year":"2015","journal-title":"Br. J. 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