Time to death in the remaining patients ranged from 3.3 to 28 months. None of the patients that presented with local disease only went on to develop visceral metastatic

disease. Results demonstrate that the “first in man” EUS-FNI of DNA Damage inhibitor recombinant poxvirus for treatment of pancreatic adenocarcinoma was well tolerated with the complete regimen suggesting an encouraging period of stable disease. While not powered to demonstrate a clinical effect, the results suggest a prolongation in survival of patients without preexisting metastatic disease, with none of these patients going on to develop metastatic disease. If these results were maintained in a larger Phase 2 study, it would be consistent with the generation of an endoscopically delivered tumor-specific immune therapy with anti metastatic activity. This study is supported by the NCI Cancer Therapeutics Evaluation Program (CTEP) and by NCI U01-CA07031 and P30-CA72720. “
“Endoscopic Ultrasound guided Radiofrequency Ablation (EUS-RFA) of pancreatic cystic neoplasms and neuroendocrine tumors (NET) have been previously described. The aim of this report is to outline the feasibility, safety, complications and early results of EUS-RFA in pancreatic neoplasms using a novel probe. Eight patients underwent EUS-RFA of a neoplastic

lesion in the head of the pancreas. A novel monopolar radiofrequency (RF) catheter (1.2mm Habib EUS-RFA catheter, Emcision Ltd, London) was placed through a 19 or 22 gauge fine needle aspiration (FNA) needle after FNA was performed. selleck Eight patients [median age of 65 (range 27 - 82) years and 7 female and 1 male] were recruited in a prospective multicenter trial. Six had a pancreatic cystic neoplasm (four a mucinous cyst, one had IPMN and one a microcystic adenoma) and two had a NET in the head of pancreas (previously documented with diagnostic FNA cytology Smoothened and not suitable for surgical intervention). The mean size of the cystic neoplasm and NET were 36.5mm (SD +/−17.9mm) and 27.5mm (SD +/−17.7mm) respectively. RF (Rita or Erbe generator)

was applied at 5 watts, 15 watts, 20 watts and finally 25 watts in 3, 2, 2 and one patients respectively over 90 sec for each watt setting. The median number of applications were 4.5 (range 2 – 7). Patients with a cystic neoplasm and one patient with NET had one session of RFA each, whilst a second patient with NET had two sessions of RFA. The EUS-RFA was completed in all patients. Amongst the 6 patients with a cystic neoplasm, the post procedure imaging in 3-6 months showed complete resolution of the cysts in 2 patients, whilst in 3 patients there was 48.4% reduction [mean pre RF 38.8mm (SD +/−21.7mm) vs. mean post RF 20mm (SD +/−17.1mm)] in size. Using cross sectional imaging in 2 patients with NET, a change in vascularity and central necrosis after EUS-RFA was demonstrated. There were no episodes of pancreatitis, perforation or bleeding within 48 hours of the procedure.