91 - Pain Mitigation in Pancreatic Adenocarcinoma: An Interim Analysis of Neurolysis via Transvascular RF Energy-Based Ablation

Monday, March 31, 2025

12:10 PM – 1:10 PM CT

Location: Music City Center, Expo Poster Area

Author/Co-author(s)

AS

Askar Sabirov, MD

Interventional Cardiologist
AKFA Medline Hospital, Tashkent, Uzbekistan, Uzbekistan
RS

Rob Schwartz, MD

Chief Medical Officer
Autonomix Medical, Inc., United States

Poster Presenter(s)

Bela Kis, MD, PhD, FSIR (he/him/his)

Chief of Interventional Radiology
Moffitt Cancer Center, United States

Purpose: The purpose of the study was to develop a clinical method for delivery of percutaneous transvascular RF energy to ablate peripheral system nerves and mitigate pain in patients with pancreatic cancer.

Materials and Methods: 12 patients with severe abdominal pain from stage 4 pancreatic cancer were enrolled and 11 treated with percutaneous transvascular energy between March 2024 and September 2024 (7 males/5 females). Angio-CT/MRI were used to assess tumor anatomy/location and plan the procedure. After accessing the vessel through a standard transfemoral or transbrachial approach, transvascular RF energy was delivered via catheter sequentially to multiple vascular sites. All treated patients were evaluated within 24 hours, after 24 hours, 7 days, 4-6 weeks, 3-months and 6-months post-procedure for the following outcomes: adverse events, target tissue changes/effects, pain severity (VAS, 1-10), quality of life assessment (EORTC-30, 0-7), opioid use, and survival status. Placement of the catheter in the celiac trunk was assessed for each patient as Successful or Not Successful during the ablation procedure.

Results: At the data cutoff date (September 26, 2024), 11 of the 12 enrolled patients were treated. 1 patient was enrolled and not treated due to unsuccessful catheter placement because of an existing celiac trunk stenosis. There were 3 severe adverse events (3 patients succumbed to their disease and were expected outcomes not related to the procedure), 2 events of expected arterial constrictions due to spasms and temporary artery occlusion, and 1 event unrelated to the procedure. 8 patients were treated using femoral access and 3 patients using brachial access. 8 of 8 patients with femoral access responded to treatment, while 3 of 3 patients with brachial access showed no improvement in pain scores. Across the total population, pain relief occurred as early as 24 hours post-procedure with a mean pain score of 2.59, and a mean pain reduction of 3.64 (baseline of 7.4 to 3.77) or 49% improvement on the VAS pain scale at 7 days post-procedure. Responding femoral patients represented 73% of treated patients with a mean 5.44 reduction (baseline of 7.75 to 2.3) or 70% improvement at 7 days post-procedure. All responders went to zero opioid use, and no patients needed a dose increase.

Conclusion: This study supports the feasibility of safe and effective neurolysis of the Celiac Plexus with transvascular catheter-based RF ablation to substantially reduce pain while eliminating opioid drugs in late-stage pancreatic cancer.