Presenter: Victor Manuel Correa Santillan MD | Instituto Jalisciense de Cancerología / Hospital Civil de Guadalajara Background: Pancreatic cancer is one of the pathologies that determine a poor prognosis, since it presents advanced stages at the time of diagnosis, with an overall 5-year survival < 5%. It is estimated that there was 495,773 new cases worldwide and many of these patients had ECOG 0-2 at the time of diagnosis.(1) Efforts have been made to develop new treatments to improve the care of patients with locally advanced pancreatic cancer, as a result of this, we have novel alternatives such as irreversible electroporation, which consists of inserting special needles into the tumor; Short electrical pulses of a high voltage current are then passed through the needles. The goal is to destroy cancer cells.(2) Methods: Describe the results of treatment of a patient with locally advanced pancreatic cancer using irreversible transurgical electroporation. In our institution for the first time. Results: A 58-year-old male presented as an outpatient with a 6-week history of progressive jaundice and weight loss of more than 8 kg. His laboratory test was CA 19-9 of 615U/ml, total bilirubin 19mg/dl, direct bilirubin 11.18 mg/dl, alkaline phosphatase 481U/L, gamma-glutamyl transferase of 849U/L. The cholangioresonance showed intra- and extrahepatic bile duct dilation with a 2cm mass in the head of the pancreas, with infiltration of the portal vein. The ERCP confirms the finding of a pancreatic head tumor, brush cytology is done, and drainage of the bile duct is achieved with a 16 Fr biliary stent. The cytology analysis shows inflammatory changes with atypia. Induction chemotherapy is started with six cycles of FOLFIRINOX; 8 weeks later, a Whipple procedure is attempted, during surgery infiltration of more than 180 degrees of the vena cava is seen; therefore, the surgery is aborted. Four weeks later, irreversible pancreatic electroporation is scheduled with three needles, two cycles, and two fields of trans-surgical depth, which was completed without complications. After the procedure, the chemotherapy continued with FOLFOX for four cycles and changed to XELOX / CAPEOX for six cycles due to gastrointestinal intolerance. Four months after chemotherapy completion, a PET-CT scan showed retroperitoneal lymph node activity without evidence of the pancreatic tumor; due to these findings, thirty sessions of Intensity-Modulated Radiotherapy was started. Conclusion: The evidence supporting the use of this technology reports a benefit in overall survival from 28 months to 85 months and overall progression-free periods up to 12 months, with a solid base of safety reporting a mortality rate of 2% to 3% to 90 days. And this is reflected in stable ECOGs for a longer time. (2,3) Although in Mexico there is the possibility of using this type of technology, they are limited by their high cost, even so, The Instituto Jalisciense de Cancerología is a pioneer in the comprehensive management of locally advanced pancreatic cancer, positioning itself as a reference center in the country. Bibliography 1. International Agency for Research on Cancer. GLOBOCAN 2020 2. National institute for Hearth and Care Excellence, Irreversible electroporation for treating pancreatic cancer, Interventional procedures guidance, 3. Balaban E and Col, 2016 Locally Advanced, Unresectable Pancreatic Cancer