Prostate Cancer Treatment with Irreversible Electroporation (IRE)

Irreversible Electroporation (IRE): A Novel Advancement in Prostate Cancer Treatment

Introduction

Irreversible Electroporation (IRE) is an emerging technology that utilizes high-voltage electrical pulses to destroy cancerous cells without causing thermal damage to surrounding tissues. Research indicates that this method can serve as a safe option for treating prostate cancer, preserving urinary and sexual functions in over 90% of cases. Recent studies (2023–2025), such as the PRESERVE trial, have confirmed the safety and efficacy of irreversible electroporation in treating prostate cancer in patients with intermediate risk, achieving a negative biopsy rate at the treatment site of approximately 71% after 12 months, although recurrence rates may reach up to 33%. IRE holds promise as an alternative to invasive treatments like prostatectomy or radiotherapy, particularly for tumors located near critical vascular structures, but long-term studies are still needed.

In Iran, Pars Tarava Company, as the first manufacturer of electroporation and electrochemotherapy devices, plays a pivotal role in providing access to this technology.

What is Irreversible Electroporation?

Irreversible Electroporation (IRE) is an advanced medical technology that uses high-voltage electrical pulses between electrodes to eliminate target tissues without causing thermal damage. This method creates permanent pores in the cell membrane, leading to cell death, and the enzymes released from dead cells affect adjacent cells, ultimately destroying cancerous tissue. IRE has been developed as a clinical alternative to traditional methods such as radical surgery or radiotherapy, particularly for non-resectable tumors located near critical vascular structures.

This technology has been evaluated in over 50 independent clinical trials, with its success confirmed in treating prostate, pancreatic, and liver tumors. Recently, more extensive studies have assessed IRE in larger patient cohorts and in combination with novel therapies.

For more information about this technology, refer to the article Irreversible Electroporation (IRE): A Novel Technology for Eliminating Cancerous Tumors.

History and Development of IRE

The history of IRE is rooted in fundamental scientific principles, progressing from laboratory data and animal studies to human clinical trials. The initial concepts of electroporation were introduced in the 18th century, but its application in cancer treatment gained momentum in recent decades. Early animal studies demonstrated that IRE could ablate tissue without damaging blood vessels or nerves. In the 2010s, IRE entered the clinical phase and is currently at the IDEAL 2B stage, indicating the need for long-term studies.

In Iran, Pars Tarava Company, as the first manufacturer of electroporation and electrochemotherapy devices, has localized this technology and facilitated its accessibility (contact number: +989024051862). The company, adhering to international standards, produces devices that are both safe and effective.

Mechanism of Action of IRE in Cancer Treatment

Reversible vs. Irreversible Electroporation

IRE employs short electrical pulses (microseconds to milliseconds) between 2 to 6 electrodes, generating a strong electric field (up to 1500 volts per centimeter). This field renders the cell membrane permeable, disrupting cellular homeostasis and leading to apoptosis or necrosis.

This non-thermal method preserves non-cellular structures such as blood vessels and ducts, distinguishing it from thermal methods like cryotherapy or HIFU. As a result, IRE avoids the heat sink effect (which occurs near blood vessels).

This characteristic makes IRE ideal for treating tumors near the urethra or erectile nerves in the prostate. Laboratory studies have shown that IRE can selectively target cancerous cells while preserving surrounding healthy tissues.

Application of IRE in Prostate Cancer

Prostate cancer is the second most common cancer in men, and IRE has been proposed as a focal therapy for localized cases with low to intermediate risk. In clinical studies, irreversible electroporation for prostate cancer treatment has been evaluated in over 283 patients, with improvement observed in 91–100% of cases, preservation of erectile function in 79–100% of men, and recurrence rates ranging from 0–33%. Current evidence considers IRE a salvage therapy for prostate cancer.

Recent Studies and Clinical Outcomes (2023–2025)

In recent years, multiple studies have evaluated IRE. For instance, the PRESERVE trial (NCT04972097), published in 2025, examined IRE in 121 patients with intermediate risk. The results showed a negative biopsy rate of 71% at the treatment site after 12 months, with an average PSA reduction of 68% at 6 months. Grade 3 adverse events occurred in only 8.3% of cases, and no grade 4 events were reported. This study confirmed the safety and efficacy of IRE, leading to FDA approval for the irreversible electroporation device in December 2024.

An international multicenter study in 2024 evaluated irreversible electroporation for prostate cancer treatment in 411 patients, reporting a one-year negative biopsy rate of 66%, with urinary and sexual function preserved in over 90% of cases. Adverse events, as classified by CTCAE, were primarily grade 1–2. Another study in 2025 on elderly patients (aged 66–77) showed that irreversible electroporation significantly reduced PSA levels (average nadir of 0.78 ng/mL), with a recurrence rate of 27.3% at 30 months and minor adverse events, including urinary issues, in 27.3% of cases.

A systematic review published in 2024, which covered 19 studies and 1452 patients, described IRE as a safe treatment with a low local recurrence rate, but emphasized the need for long-term follow-up. Combining IRE with radiotherapy (RTIRE) in a 2024 study enhanced its efficacy in intermediate-risk cases. Advances in 2025 confirm the use of IRE for localized tumors, with a focus on safety and preservation of quality of life.

Table Comparing Key IRE Studies in Prostate Cancer (2023–2025)

Study	Year	Number of Patients	Key Findings	Adverse Events
PRESERVE Trial	2025	121	Negative biopsy rate 71%, PSA reduction 68%	Grade 3: 8.3%
Multi-center International	2024	411	Negative biopsy rate 66%, function preserved 90%	Mostly grade 1–2
Preliminary Follow-up in Elderly	2025	11	PSA reduction to 0.78 ng/mL, recurrence 27.3%	Urinary: 27.3%
Systematic Review	2024	1452	High safety, low recurrence	Low classification
RTIRE Trial	2024	N/A (Phase II)	Combined with RT, better control	Under investigation

This table highlights the positive trend of IRE, but the variability in recurrence rates underscores the need for careful patient selection.

Advantages, Challenges, and Future Prospects

IRE offers advantages such as preserving critical structures, reducing sexual and urinary complications, and applicability in salvage cases. Challenges include local recurrence rates and the need for advanced equipment. In the future, combining IRE with immunotherapy or targeted therapies could enhance its efficacy.

In Iran, Pars Tarava Company, by producing IRE devices, has made this technology accessible and could transform cancer treatment in Iran. For consultation, contact us via WhatsApp, Telegram, or phone at +989024051862.

Conclusion

IRE represents a significant advancement in prostate cancer treatment, striking a balance between cancer control and quality-of-life preservation. Studies from 2023 to 2025 have confirmed its safety and efficacy; however, long-term data are still needed. With the support of companies like Pars Tarava, IRE could become a new standard in Iran.

Sources

Tagged Electrochemotherapy