EFFECTS OF IRREVERSIBLE ELECTROPORATION ON THE TUMOR MICROENVIRONMENT IN PANCREATIC DUCTAL ADENOCARCINOMA: A NARRATIVE REVIEW

Anna Skrzypek; Hanna   Maruchniak; Wiktoria Marzec; Paulina Biedroń; Maciej Hutkowski; Mikołaj Zbrożek; Zuzanna Chwostek; Bartłomiej Kosiarski; Patrycja Markowicz; Krzysztof Biłyk

doi:10.31435/ijitss.2(50).2026.5783

Authors

Anna Skrzypek Czerniakowski Hospital, Warsaw, Poland https://orcid.org/0009-0007-6771-3186
Hanna Maruchniak Czerniakowski Hospital, Warsaw, Poland https://orcid.org/0009-0003-8735-9912
Wiktoria Marzec Specialist Hospital named after Florian Ceynowy in Wejherowo, Wejherowo, Poland https://orcid.org/0009-0006-6395-6263
Paulina Biedroń Praski Hospital of the Transfiguration of the Lord, Warsaw, Poland https://orcid.org/0009-0008-8461-2958
Maciej Hutkowski Independent Public Healthcare Complex in Pruszków, Pruszków, Poland https://orcid.org/0009-0006-9811-8681
Mikołaj Zbrożek Prof. W. Orłowski Independent Public Clinical Hospital, Warsaw, Poland https://orcid.org/0009-0007-8873-6184
Zuzanna Chwostek Medical Center in Łańcut, Łańcut, Poland https://orcid.org/0009-0001-8177-4168
Bartłomiej Kosiarski Central Clinical Hospital, Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0005-2499-1245
Patrycja Markowicz Praski Hospital of the Transfiguration of the Lord, Warsaw, Poland https://orcid.org/0009-0001-3986-1751
Krzysztof Biłyk Independent Public Specialist Western Hospital named after St. John Paul II, Poland https://orcid.org/0009-0006-2374-4231

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5783

Keywords:

irreversible electroporation , pancreatic ductal adenocarcinoma, tumor microenvironement

Abstract

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies, largely due to late diagnosis, aggressive tumor biology, and marked resistance to conventional treatment and immunotherapy. A major contributor to therapeutic failure is the highly immunosuppressive and desmoplastic tumor microenvironment (TME), which limits drug delivery, restricts cytotoxic immune-cell infiltration, and promotes immune evasion.

This narrative literature review evaluates the effects of irreversible electroporation (IRE) on the PDAC microenvironment and assesses its potential role as an immune-sensitizing strategy capable of enhancing antitumor immunity and improving responsiveness to immunotherapy.

English-language review articles, preclinical and clinical studies published between 2011 and 2025, were investigated, with a particular focus on evidence from 2020 to 2025. The reviewed literature suggests that IRE can induce immunogenic cell death by releasing danger-associated molecular patterns, enhance antigen presentation, remodel the fibrotic stroma, reduce hypoxia, and promote infiltration of cytotoxic T lymphocytes. Several studies also report reductions in immunosuppressive cell populations and improved responses to immune checkpoint blockade following IRE.

Overall, IRE appears to be a promising local treatment modality with systemic immunomodulatory potential in PDAC. However, most evidence remains preclinical, and further prospective clinical studies are required to define its long-term efficacy, safety profile, optimal technical parameters, and best integration with systemic immunotherapy.

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