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Electrochemotherapy for cutaneous kaposi sarcoma: a European register-based cohort study from the international network for sharing practices of electrochemotherapy (InspECT)

Quaglino, P.
Brizio, M.
Bertino, G.
Kis, E.
Mascherini, M.
Battista, M.
Kunte, C.
Mowatt, D.
Russano, F.
Giorgione, R.
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Abstract
INTRODUCTION: Kaposi sarcoma (KS) is a cancer of endothelial cells involving the skin and visceral organs. Electrochemotherapy (ECT) is an alternative treatment option for patients with cutaneous malignancies of skin and non-skin origin not suitable for conventional treatments. ECT exerts anti-tumour activity through enhanced drug delivery to tumour cells and cytotoxicity, inducing immunogenic tumour cell death and through a vascular-disrupting effect. MATERIALS AND METHODS: In this multi-institutional prospective, observational study, we aimed to evaluate the outcomes of using ECT as a treatment modality for cutaneous Kaposi's Sarcoma within the InspECT (International Network for Sharing Practice on ECT) registry. Patients with superficial lesions of Kaposi Sarcoma from 19 European centres were included. They underwent at least one ECT session with bleomycin performed following the European Standard Operating Procedures, between March 2011 and June 2024. RESULTS: The analysis included 82 patients (mean age 71 years; median number of lesions/patient 2). Side effects were reported as mild and easily manageable. The response to treatment per patient was 80 % complete and 13 % partial. In the multivariate model, time since diagnosis to ECT and small tumour size showed a significant association with a complete response. One-year local progression-free survival (LPFS) in the whole population was 93 %, 2 years LPFS was 89 %. CONCLUSIONS: In the present study, ECT showed antitumor activity and a favourable safety profile in patients with cutaneous Kaposi Sarcoma either not suitable for conventional treatments or that refused them. Better results were obtained in small tumours (<3 cm) using hexagonal electrodes.
Affiliation
Department of Medical Sciences, Dermatologic Clinic, University of Turin, Torino, Italy. Electronic address: Pietro.quaglino@unito.it. Department of Medical Sciences, Dermatologic Clinic, University of Turin, Torino, Italy. Department of Otolaryngology Head Neck Surgery, IRCCS Policlinico San Matteo Foundation, University of Pavia, Italy. Department of Dermatology and Allergology, University of Szeged, Hungary. Clinica Chirurgica 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy. Scientific & Medical Department, IGEA S.p.A, Carpi, Modena, Italy. Department of Dermatosurgery and Dermatology, Artemed Hospital, Munich, Germany. Department of Surgery, The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom. Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, IRCCS Veneto Institute of Oncology IOV, Padua, Italy. Dermatologic Clinic, University of Eastern Piedmont, Novara, Italy. Department of Plastic Surgery, Cork University Hospital, Wilton, Cork, Ireland. Department of Dermatology, Medical Center of Johannes Gutenberg-University, Mainz, Germany. Plastic Surgery Unit, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy. Unit of Surgery and Advanced Oncological Therapies, Hospital of Forlì, Forlì, Italy. Istituti Fisioterapici Ospitalieri - IFO, Roma, Italy. Institute of Oncology Ljubljana, Department of Experimental Oncology, Ljubljana, Slovenia. Department of Plastic Surgery, St George's University Hospitals NHS Foundation Trust, London, United Kingdom.
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2025
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Quaglino P, Brizio M, Bertino G, Kis E, Mascherini M, Battista M, et al. Electrochemotherapy for cutaneous Kaposi Sarcoma: A European register-based cohort study from the International Network for Sharing Practices of electrochemotherapy (InspECT). European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 2025 Aug;51(8):110099. PubMed PMID: 40347711. Epub 2025/05/11. eng.
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