Ann: Pancreatic cancer clinical study update, page-25

There is nothing new about brachytherapy ie applying radiation directly to the tumour. The concept has been around for decades and is successfully applied to various cancers. The difficulty is in applying it accurately and in sufficient, tumoricidal dose with acceptable toxicity to adjacent structures.
It is conceivable that this be applied to pancreatic cancer but there are a number of hurdles it must overcome to get there.

A big problem for Oncosil is the mode of delivery. As I understand it (correct me if i am wrong), unlike the Sirtex treatment, Oncosil will be administered by gastroenterologists skilled in endoscopic ultrasound, not interventional radiologists. There are lots of IRs around who can cannulate an hepatic artery. There are far fewer gastros with the skills required for this treatment. This may limit wider application if it is shown to be effective.

There have been dramatic improvements in external beam radiotherapy and medical therapies for pancreatic ca. so Oncosil will have to be shown to be superior to current comparators. There have also been substantial improvements in chemotherapy. Problem is that it is biologically a nasty disease with terrible prognosis.

With your regards to your comments about SIR Spheres, all tumours are vascularised, just that some are more vascular than others. The spheres embolise (ie lodge) when they reach a vessel they can no longer fit through (-30 microns) - that is how they are kept in place.

Most people envisage a well defined golfball sized tumour into which the product is injected. These tumours are often infiltrative with poorly defined borders, adjacent to vessels and viscera, and i expect it will be technically challenging to plan and to deliver the therapy.

Having said all that they have lined up some fairly impressive cancer centres to take a look at it.

Just some random thoughts.