Death from cancer is invariably related to metastatic disease. Surgery for colorectal cancer that has spread to the lungs is believed to prolong survival in selected patients. However, lung surgery is associated with loss of lung function, a surgical recovery period, and potential complications. It is possible to place a needle into a lung cancer under CT guidance and thermally ablate or "burn" the cancer avoiding a surgery. This avoids the invasiveness of surgery, the recovery time of surgery, and preserves lung function. However, this technique also has limitations. Some of the challenges related to current thermal ablation have been related to inconsistent ablation zones. Several factors lead to variable ablation zones including flowing adjacent blood vessels which can provide a "heat sink" and limit sufficient heating of the cells near vessels. Another potential limitation of thermal ablatio, specifically associated with the lung, has been the ability to have satisfactory thermal conduction. Irreversible electroporation (IRE) is a new form of tissue ablation that relies on electric fields to create cell membrane holes that lead to cell death. This process is thermally independent and would not be associated with the "heat sink" challenge found with thermal ablation tools. In animals IRE creates a predictable ablation zone that can be modeled with electric field maps. The main objective is to investigate the application of IRE as a reliable lung ablation tool for patients with colorectal metastases to the lung. This study is a human safety study with several other corollary objectives. If success is determined with this project, a larger study comparing IRE ablation's effectiveness versus other therapies may be planned. Results from the current study on colorectal cancer in the lung will have broad implications for other types of cancer as well since IRE can be applied to other parts of the body and other types of cancer.
Colorectal cancer is the third most common cancer death for both men and women, and the lungs are the most common extra-abdominal site of metastases in patients affected by colorectal cancer. Many studies have shown that lung surgery on selected patients with colorectal lung metastases increases survival, however, the surgery is accompanied by loss of lung function, surgical recovery time, and potential complications. The current proposal investigates the use of a new, non-surgical, needle-based approach to eradicate lung metastases from colorectal cancer.