We at Mayo Clinic in Florida use IRE for unresectable PDAC in combination with systemic chemotherapy and radiation treatment. This modality is not widely used or have available trials due to the lack of efficacy against cancer when compared to standard treatment. It is employed occasionally for patients who are not candidates for standard treatment. IRE should only be used for patients that have no other options based on sound evidence, not for theoretical benefits touted by the manufacturer or those who stand to gain financially from its use.