Electrochemotherapy of superficial tumors - current status: basic principles, operating procedures, shared indications, and emerging applications
AffiliationDepartment of Surgery Oncology and Gastroenterology (DISCOG), University of Padua, Italy
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AbstractTreatment of superficial tumors with electrochemotherapy (ECT) has shown a steep rise over the past decade and indications range from skin cancers to locally advanced or metastatic neoplasms. Based on reversible electroporation, which is a physical method to achieve transient tumor cell membrane permeabilization by means of short electric pulses, ECT increases cellular uptake of bleomycin and cisplatin and their cytotoxicity by 8,000- and 80-fold, respectively. Standard operating procedures were established in 2006 and updated in 2018. Ease of administration, patient tolerability, efficacy across histotypes, and repeatability are peculiar advantages, which make standard ECT (ie, ECT using fixed-geometry electrodes) a reliable option for controlling superficial tumor growth locally and preventing their morbidity. Consolidated indications include superficial metastatic melanoma, breast cancer, head and neck skin tumors, nonmelanoma skin cancers, and Kaposi sarcoma. In well-selected patients with oropharyngeal cancers, ECT ensures appreciable symptom control. Emerging applications include skin metastases from visceral or hematological malignancies, vulvar cancer, and some noncancerous skin lesions (keloids and capillary vascular malformations). Repeatability and integration with other oncologic therapies allow for consolidation of response and sustained tumor control. In this review, we present the basic principles of ECT, recently updated operating procedures, anesthesiological management, and provide a synthesis of the efficacy of standard ECT across histotypes.
CitationCampana LG, Miklavcic D, Bertino G, Marconato R, Valpione S, Imarisio I, et al. Electrochemotherapy of superficial tumors - current status: basic principles, operating procedures, shared indications, and emerging applications. Semin Oncol. 2019.
JournalSeminars in Oncology
- Utility of electrochemotherapy in melanoma treatment.
- Authors: Testori A, Rossi CR, Tosti G
- Issue date: 2012 Mar
- Electrochemotherapy - Emerging applications technical advances, new indications, combined approaches, and multi-institutional collaboration.
- Authors: Campana LG, Edhemovic I, Soden D, Perrone AM, Scarpa M, Campanacci L, Cemazar M, Valpione S, Miklavčič D, Mocellin S, Sieni E, Sersa G
- Issue date: 2019 Feb
- [Electrochemotherapy: mechanism of action and clinical results in the locoregional treatment of patients with skin cancers and superficial metastases].
- Authors: Campana LG, Marconato R, Sieni E, Valpione S, Corti L, Mocellin S, Rossi CR
- Issue date: 2016 Aug
- Treatment efficacy with electrochemotherapy: A multi-institutional prospective observational study on 376 patients with superficial tumors.
- Authors: Campana LG, Testori A, Curatolo P, Quaglino P, Mocellin S, Framarini M, Borgognoni L, Ascierto PA, Mozzillo N, Guida M, Bucher S, Rotunno R, Marenco F, De Salvo GL, De Paoli A, Rossi CR, Bonadies A
- Issue date: 2016 Dec
- Electrochemotherapy of unresectable cutaneous tumours with reduced dosages of intravenous bleomycin: analysis of 57 patients from the International Network for Sharing Practices of Electrochemotherapy registry.
- Authors: Rotunno R, Campana LG, Quaglino P, de Terlizzi F, Kunte C, Odili J, Gehl J, Ribero S, Liew SH, Marconato R, Brizio M, Curatolo P
- Issue date: 2018 Jul