Timothy McClure, MD, discusses focal therapy with irreversible electroporation

In this video, Timothy D. McClure, MD, discusses focal therapy with irreversible electroporation (IRE), specifically highlighting its benefits and limitations compared with other treatment options.

“We have [a lot] of options available to us: HIFU, cryoablation, [and] IRE. I've gravitated towards IRE for a couple reasons,” he explained. “One is you can treat throughout the prostate—so, you can treat anterior, you can treat posterior, [and] you can treat apical lesions—whereas both cryo and HIFU have limitations with each of those spots. For example, HIFU has a hard time treating anterior lesions, and you're limited by prostate size. Cryoablation, particularly for trying to preserve potency, is limited with posterior lesions from that perspective.”

McClure is an assistant professor of urology at Weill Cornell Medical College in New York, New York.

However, McClure emphasizes the need for careful patient selection for focal therapy. While IRE is beneficial in tolerability, with less impact on urinary function or bowel toxicity, these benefits must be weighed against the limits in oncological efficacy.

“Patients really have to be really uniquely selected to be good candidates for focal therapy,” McClure explained. “Unfortunately, not all patients who come see us are good candidates, just because of the basis that most prostate cancer is multifocal. For the patient that has an MRI lesion that has grade group 2 or grade group 3 prostate cancer, that's the ideal patient for focal therapy.”