Non-thermal ablation and drug delivery by electroporation : expanding current indications beyond cancer and cardiac treatment

Miklavčič, Damijan (author), Cindrič, Helena (author), Davalos, Rafael V. (author), Deschamps, Frederic (author), Gehl, Julie (author), Kos, Bor (author), Kramar, Peter (author), Kuhelj, Dimitrij (author), Meijerink, Martijn R. (author), Soden, Declan M. (author), Štabuc, Miha (author), Serša, Gregor (author)

Background. Electroporation-Based Treatments and Therapies (EBTTs) – electrochemotherapy, irreversible electroporation, pulsed field ablation, and gene electro-transfer – use short, high-voltage electric pulses to permeabilize cell membranes, enabling non-thermal tissue ablation and enhanced local drug delivery. Although EBTTs have been used clinically for over three decades, primarily in oncology, their adoption remains limited compared to thermal ablation modalities. In contrast, cardiac pulsed field ablation (PFA) has seen rapid adoption since the first FDA device approval in December 2023. Conclusions. This expert opinion paper reviews the current clinical landscape of EBTTs in oncology and cardiac arrhythmia treatments, and focuses on emerging non-oncological and non-cardiac applications, including endoscopic pulsed electric field therapy for type 2 diabetes, bronchial rheoplasty for chronic bronchitis, bleomycin electrosclerotherapy for vascular malformations, nanosecond PFA for benign thyroid nodules, and electroporation-mediated gene delivery – and identifies key barriers to wider adoption: insufficient randomized evidence, lack of validated treatment planning tools, fragmented reimbursement, and limited standardization. We outline measures to facilitate clinical translation.

• Language: English
• Keywords: elektroporacija, ablacija s pulzirajočim poljem, elektrokemoterapija, ireverzibilna elektroporacije, genska elektrotransfekcija
• Work type: Article
• Typology: 1.02 - Review Article
• Organization: FE - Faculty of Electrical Engineering
• Publication status: Published
• Publication version: Version of Record
• Publisher: Association of Radiology and Oncology
• Year: 2026
• Number of pages: str. 319-322
• Numbering: Vol. 60, no. 3
• PID: 20.500.12556/RUL-186665
• UDC: 602.621
• ISSN on article: 1318-2099
• DOI: 10.2478/raon-2026-0040
• COBISS.SI-ID: 287787523
• Publication date in RUL: 04.09.2026

Record is a part of a journal

• Title: Radiology and oncology
• Shortened title: Radiol. oncol.
• Publisher: Association of Radiology and Oncology
• ISSN: 1318-2099
• COBISS.SI-ID: 32649472

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

• Language: Slovenian
• Keywords: electroporation, pulsed field ablation, electrochemotherapy, irreversible electroporation, gene electrotransfer