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Could Precancerous Cells Be Cleared Without Removing the Bladder? U.S. Team Uses an Electrical Pulse Device to Prevent Bladder Cancer Recurrence
Researchers are adapting irreversible electroporation into a flexible catheter in an attempt to remove diseased cells from the bladder’s innermost layer and allow healthy tissue to regenerate. The NIH-supported project remains in preclinical development and will first use bladder-on-a-chip models built from patient cells to test safety and effectiveness.
The challenge of treating bladder cancer lies not only in removing the existing tumor, but also in the possibility that cancer may reappear elsewhere in the bladder lining. A team led by the University of Massachusetts Amherst is developing an organ-sparing device intended to remove cells in the bladder’s inner layer that may harbor precancerous lesions before new tumors form.
The five-year project has received up to $3.45 million in funding from the U.S. National Institutes of Health. The team is targeting the urothelium, the approximately 0.1-millimeter-thick bladder lining that comes into direct contact with urine. The concept is to remove an area only three to four cell layers thick, clearing diseased cells that are difficult to locate while preserving the bladder wall and organ function and allowing healthy epithelium to regrow.
The core technology is “irreversible electroporation.” This method uses brief electrical pulses to disrupt cell membranes, and existing clinical applications typically use needle electrodes to treat localized solid tumors. The research team is attempting to adapt it into a flexible catheter so that the electric field can act along the irregularly shaped, relatively large inner cavity of the bladder while affecting only the thin, outermost layer of tissue. Balancing uniform coverage with treatment depth will be a key engineering challenge for the device.
To make preclinical testing more closely resemble conditions in the human body, the researchers will use patient-derived cells to build “bladder-on-a-chip” microphysiological models and assess the device’s effects on the urothelium and its regeneration. Compared with simple cell cultures, chip models are expected to better simulate tissue structure and the local environment. However, they still cannot fully reproduce the human immune response, urine exposure, wound healing, or the long-term recurrence process.
The research is led by University of Massachusetts Amherst engineering researcher Govind Srimathveeravalli in collaboration with Memorial Sloan Kettering Cancer Center urologic surgeon Jonathan Coleman. The university said the funding does not include human clinical trials. Before the project can advance to the next stage, the team must demonstrate that the device can consistently control the area of removal without causing perforation, fibrosis, impaired bladder function, or other unacceptable harm.
The strategy also rests on an important hypothesis that has yet to be validated: that broadly removing precancerous cells from the urothelium can reduce recurrence more effectively than repeatedly treating newly formed tumors. Currently available public information does not provide animal study results, the number of patient-derived chip models, or quantified performance data, and the relevant details appear only in materials released by the research institution. At this stage, it therefore represents a specific organ-sparing research and development pathway, rather than an option that can already replace current treatments.