Trans-Arterial Micro-Perfusion (TAMP) for Pancreatic Cancer

City of Hope® Cancer Center Duarte near Los Angeles is one of the first cancer centers in the nation to offer trans-arterial micro-perfusion (TAMP), an innovative approach to delivering chemotherapy for some patients with locally advanced pancreatic cancer. This minimally invasive procedure is designed to deliver chemotherapy near the tumor while potentially limiting exposure to healthy tissues throughout the body.

Pancreatic tumors can be challenging to treat because their dense tissue and limited blood supply may make it difficult for chemotherapy given through a vein to reach the tumor in sufficient amounts.

TAMP is designed to address this challenge by delivering chemotherapy through an artery near the pancreatic tumor. An interventional radiologist uses a specialized, Food and Drug Administration (FDA)-cleared catheter to deliver the medicine through the blood vessel supplying the tumor, allowing chemotherapy to wash the targeted area.

“Instead of relying solely on chemotherapy traveling throughout the bloodstream, trans-arterial micro-perfusion allows us to focus drug delivery near the tumor,” says Jonathan Kessler, M.D., chief of the Division of Interventional Radiology at City of Hope Duarte.

TAMP is minimally invasive and does not require major surgery. Most patients can return home the same day.

TAMP is designed to:

• Deliver chemotherapy near the tumor to concentrate treatment in the targeted area
• Potentially reduce exposure to healthy tissues compared with chemotherapy delivered throughout the body
• Provide a minimally invasive treatment option that typically doesn’t require major surgery
• Fit into a personalized treatment plan developed by a team of pancreatic cancer specialists

“TAMP is a new way to think about how we deliver chemotherapy,” Dr. Kessler says. “The goal is to bring the treatment closer to where it’s needed.”

A patient’s care team will determine whether TAMP may offer potential benefits based on various factors, including cancer type and overall treatment plan.

Trans-arterial micro-perfusion may be considered for some people with locally advanced pancreatic cancer, meaning cancer that has grown into nearby tissues or blood vessels but hasn’t spread to distant organs. Because every pancreatic cancer is different, doctors evaluate the diagnosis, tumor location and other characteristics, previous or current treatments and overall health before determining whether TAMP is appropriate.

At City of Hope, interventional radiologists work closely with medical oncologists, surgical oncologists, radiation oncologists and other pancreatic cancer specialists. Together, they consider whether a localized drug-delivery approach such as TAMP may be suitable as part of a personalized care plan.

TAMP uses image-guided techniques to precisely deliver chemotherapy near the pancreatic tumor. The procedure generally involves the following steps:

1. A catheter is inserted. An interventional radiologist makes a small opening to access an artery and guides a specialized catheter into the blood vessel.
2. The catheter is guided to the tumor. Using imaging, the doctor carefully directs the catheter to the blood vessel supplying the pancreatic tumor.
3. Chemotherapy is delivered. The medicine is administered through the catheter near the tumor.
4. The catheter is removed. Once treatment is finished, the catheter is removed and the access site is treated. Most patients can go home the same day.

“TAMP is performed without the need for major surgery,” Dr. Kessler adds. “Our goal is to provide precise drug delivery while making the procedure as straightforward as possible for patients.”

At City of Hope, trans-arterial micro-perfusion is offered through the Division of Interventional Radiology as part of its high-volume Pancreatic Cancer Program. This multidisciplinary approach brings together specialists who evaluate cancer from multiple perspectives and develop an individualized treatment plan.