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Rullo V, Castellaneta F, D’Antonio S, De Rosa A, Grieco MP, Fabrizio T. Electrochemotherapy in Kaposi's Sarcoma Patients: From the Gold Standard Strategy to Locally Advanced Cutaneous and Subcutaneous Lesions. Cancers (Basel) 2024; 16:1295. [PMID: 38610972 PMCID: PMC11010848 DOI: 10.3390/cancers16071295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/16/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Electrochemotherapy (ECT) is one of the newest therapeutic strategies employed as a medical procedure for skin neoplasms' treatment, especially for classic Kaposi's sarcoma (CKS). The aim of this study was to demonstrate ECT clinical response and the local control of CKS disease. The primary endpoint was to value the worth and efficacy of this local therapy in CKS skin lesions' treatment. In total, 19 CKS patients were enrolled, 14 males and 5 females with median age at diagnosis of 72. Complete response (CR) has been gained in 12 patients after first ECT attempt; meanwhile, 3 and 4 out of 19 patients obtained a partial response (PR), so they underwent a second and third ECT treatment, respectively. Clinical response was evaluated during the entire timeframe of the follow-up, which ranged between 3 months and 4 years with a median of 18 months. The control of CKS skin lesions still represents a challenge for surgeons and oncologists. Nevertheless, according to this and other authors' recent experiences, ECT could be considered the gold standard strategy for early-stage patients, but at the same time it could be considered as a valid option in controlling Kaposi's sarcoma locally advanced lesions.
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Affiliation(s)
- Vincenzo Rullo
- Division of Plastic Surgery, IRCCS-Centro di riferimento Oncologico della Basilicata, Via Padre Pio, 1, 95098 Rionero in Vulture, Italy; (V.R.); (F.C.); (S.D.); (A.D.R.); (M.P.G.)
- Division of Plastic Surgery, AOU Federico II, Via S. Pansini, 5, 80131 Naples, Italy
| | - Francesco Castellaneta
- Division of Plastic Surgery, IRCCS-Centro di riferimento Oncologico della Basilicata, Via Padre Pio, 1, 95098 Rionero in Vulture, Italy; (V.R.); (F.C.); (S.D.); (A.D.R.); (M.P.G.)
| | - Santolo D’Antonio
- Division of Plastic Surgery, IRCCS-Centro di riferimento Oncologico della Basilicata, Via Padre Pio, 1, 95098 Rionero in Vulture, Italy; (V.R.); (F.C.); (S.D.); (A.D.R.); (M.P.G.)
- Division of Plastic Surgery, AOU Federico II, Via S. Pansini, 5, 80131 Naples, Italy
| | - Anna De Rosa
- Division of Plastic Surgery, IRCCS-Centro di riferimento Oncologico della Basilicata, Via Padre Pio, 1, 95098 Rionero in Vulture, Italy; (V.R.); (F.C.); (S.D.); (A.D.R.); (M.P.G.)
- Division of Plastic Surgery, AOU Federico II, Via S. Pansini, 5, 80131 Naples, Italy
| | - Michele Pio Grieco
- Division of Plastic Surgery, IRCCS-Centro di riferimento Oncologico della Basilicata, Via Padre Pio, 1, 95098 Rionero in Vulture, Italy; (V.R.); (F.C.); (S.D.); (A.D.R.); (M.P.G.)
| | - Tommaso Fabrizio
- Division of Plastic Surgery, IRCCS-Centro di riferimento Oncologico della Basilicata, Via Padre Pio, 1, 95098 Rionero in Vulture, Italy; (V.R.); (F.C.); (S.D.); (A.D.R.); (M.P.G.)
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2
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Campana LG, Daud A, Lancellotti F, Arroyo JP, Davalos RV, Di Prata C, Gehl J. Pulsed Electric Fields in Oncology: A Snapshot of Current Clinical Practices and Research Directions from the 4th World Congress of Electroporation. Cancers (Basel) 2023; 15:3340. [PMID: 37444450 PMCID: PMC10340685 DOI: 10.3390/cancers15133340] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/29/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
The 4th World Congress of Electroporation (Copenhagen, 9-13 October 2022) provided a unique opportunity to convene leading experts in pulsed electric fields (PEF). PEF-based therapies harness electric fields to produce therapeutically useful effects on cancers and represent a valuable option for a variety of patients. As such, irreversible electroporation (IRE), gene electrotransfer (GET), electrochemotherapy (ECT), calcium electroporation (Ca-EP), and tumour-treating fields (TTF) are on the rise. Still, their full therapeutic potential remains underappreciated, and the field faces fragmentation, as shown by parallel maturation and differences in the stages of development and regulatory approval worldwide. This narrative review provides a glimpse of PEF-based techniques, including key mechanisms, clinical indications, and advances in therapy; finally, it offers insights into current research directions. By highlighting a common ground, the authors aim to break silos, strengthen cross-functional collaboration, and pave the way to novel possibilities for intervention. Intriguingly, beyond their peculiar mechanism of action, PEF-based therapies share technical interconnections and multifaceted biological effects (e.g., vascular, immunological) worth exploiting in combinatorial strategies.
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Affiliation(s)
- Luca G. Campana
- Department of Surgery, Manchester University NHS Foundation Trust, Oxford Rd., Manchester M13 9WL, UK;
| | - Adil Daud
- Department of Medicine, University of California, 550 16 Street, San Francisco, CA 94158, USA;
| | - Francesco Lancellotti
- Department of Surgery, Manchester University NHS Foundation Trust, Oxford Rd., Manchester M13 9WL, UK;
| | - Julio P. Arroyo
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, USA; (J.P.A.); (R.V.D.)
| | - Rafael V. Davalos
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, USA; (J.P.A.); (R.V.D.)
- Institute for Critical Technology and Applied Sciences, Virginia Tech, Blacksburg, VA 24061, USA
| | - Claudia Di Prata
- Department of Surgery, San Martino Hospital, 32100 Belluno, Italy;
| | - Julie Gehl
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, 4000 Roskilde, Denmark;
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
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Niccolò A, Elena M, Nadiane P, Barbara M, Gianlorenzo I, Dario P. Electrochemotherapy with bleomycin as an effective local treatment for Kaposi's sarcoma: a case report. Anticancer Drugs 2023; 34:589-591. [PMID: 36730383 PMCID: PMC9997621 DOI: 10.1097/cad.0000000000001427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/01/2022] [Indexed: 02/04/2023]
Abstract
An elderly female patient with a long-standing history of Kaposi's sarcoma of the lower limbs was referred to the Surgical Department after the subsequential failure of multiple lines of systemic chemotherapy. The patient was also complaining of increasing symptoms including intractable pruritus, which negatively impacted her quality of life. She underwent palliative electrochemotherapy with bleomycin (15 g/m 2 ) on the sarcomatous lesions of the left foot and ankle, which lead to complete clinical response and resolution of symptoms; no adverse events were reported. Electrochemotherapy is a valid option in the palliative treatment of Kaposi's sarcoma, as it may lead to satisfactory clinical response and symptom control.
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Bastrup FA, Vissing M, Gehl J. Electrochemotherapy with intravenous bleomycin for patients with cutaneous malignancies, across tumour histology: a systematic review. Acta Oncol 2022; 61:1093-1104. [DOI: 10.1080/0284186x.2022.2110385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Freya A. Bastrup
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mille Vissing
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Julie Gehl
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Lalanda R, Bartolo J, Carvalhal S, Abecasis N, Farricha V. Cutaneous and subcutaneous Kaposi's sarcoma lesions treated with electrochemotherapy. Int J Dermatol 2022; 62:115-119. [PMID: 35556245 DOI: 10.1111/ijd.16261] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 04/03/2022] [Accepted: 04/22/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND OBJECTIVES Kaposi's sarcoma (KS) is a locally aggressive mesenchymal tumor that involves the lymphovascular system, with a tendency to become multifocal. Electrochemotherapy (ECT) is considered a valuable treatment option in selected patients with cutaneous and subcutaneous KS lesions. METHODS We report a retrospective study that included 14 classic and endemic KS patients that underwent ECT sessions for the treatment of KS cutaneous and subcutaneous lesions at our institution. RESULTS According to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria, our patients had an overall response rate (ORR) of 100% to the ECT treatment. A complete response (CR) was obtained in 92.8% of patients after one or more ECT sessions. Only one patient had a progressive disease (PD). The treatment was well tolerated with a low complication rate, mainly transitory local pain or skin ulceration. CONCLUSIONS ECT represents a locoregional therapy for containment and symptomatic control of classic and endemic KS cutaneous and subcutaneous lesions. Further studies including different subtypes of KS patients should also be performed.
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Affiliation(s)
- Raquel Lalanda
- Study Performed at the Portuguese Institute of Oncology of Lisbon, Lisbon, Portugal
| | - Joana Bartolo
- Study Performed at the Portuguese Institute of Oncology of Lisbon, Lisbon, Portugal
| | - Sara Carvalhal
- Study Performed at the Portuguese Institute of Oncology of Lisbon, Lisbon, Portugal
| | - Nuno Abecasis
- Study Performed at the Portuguese Institute of Oncology of Lisbon, Lisbon, Portugal
| | - Victor Farricha
- Study Performed at the Portuguese Institute of Oncology of Lisbon, Lisbon, Portugal
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He YQ, Gao Y, Gu HW, Meng XZ, Yi HC, Chen Y, Sun WY. Target-induced activation of DNAzyme for sensitive detection of bleomycin by using a simple MOF-modified electrode. Biosens Bioelectron 2021; 178:113034. [DOI: 10.1016/j.bios.2021.113034] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/28/2020] [Accepted: 01/20/2021] [Indexed: 12/26/2022]
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Ferioli M, Galuppi A, Buwenge M, Cammelli S, Perrone AM, Macchia G, Deodato F, Cilla S, Zamagni A, De Terlizzi F, Tagliaferri L, De Iaco P, Morganti AG. Electrochemotherapy in Kaposi sarcoma: A systematic review. Mol Clin Oncol 2021; 14:64. [PMID: 33680455 DOI: 10.3892/mco.2021.2226] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/09/2020] [Indexed: 11/05/2022] Open
Abstract
Kaposi sarcoma (KS) is a rare angioproliferative disorder, which is usually associated with human herpesvirus-8 infection. Electrochemotherapy (ECT) may be an option in the treatment of KS skin lesions due to the high response rate noted in neoplastic lesions of different histological types. The aim of the present systematic review was to analyse the available evidence on using ECT in the treatment of KS skin lesions. Tumor response, local control and toxicity were analyzed. In the three included studies, the complete response rate was 65-100% and the overall response rate in all studies was 100%. The treatment was well tolerated with mild and transient toxicity. However, further studies are required to fully analyze long-term disease control and to compare ECT with other local therapies used for KS.
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Affiliation(s)
- Martina Ferioli
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, I-40138 Bologna, Italy
| | - Andrea Galuppi
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, I-40138 Bologna, Italy
| | - Milly Buwenge
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, I-40138 Bologna, Italy
| | - Silvia Cammelli
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, I-40138 Bologna, Italy
| | - Anna Myriam Perrone
- Oncologic Gynaecology Unit, Department Medical and Surgical Sciences (DIMEC), University of Bologna, S. Orsola-Malpighi Hospital, I-40138 Bologna, Italy
| | - Gabriella Macchia
- Radiotherapy Unit, Gemelli Molise Hospital, Fondazione Policlinico Universitario A. Gemelli, IRCCS, I-86100 Campobasso, Italy
| | - Francesco Deodato
- Radiotherapy Unit, Gemelli Molise Hospital, Fondazione Policlinico Universitario A. Gemelli, IRCCS, I-86100 Campobasso, Italy
| | - Savino Cilla
- MedicalPhysic Unit, Gemelli Molise Hospital, Fondazione Policlinico Universitario A. Gemelli, IRCCS, I-86100 Campobasso, Italy
| | - Alice Zamagni
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, I-40138 Bologna, Italy
| | | | - Luca Tagliaferri
- Fondazione Policlinico Universitario 'A. Gemelli' IRCCS, UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, I-00168 Roma, Italy
| | - Pierandrea De Iaco
- Oncologic Gynaecology Unit, Department Medical and Surgical Sciences (DIMEC), University of Bologna, S. Orsola-Malpighi Hospital, I-40138 Bologna, Italy
| | - Alessio Giuseppe Morganti
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, I-40138 Bologna, Italy
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Brambilla L, Genovese G, Berti E, Peris K, Rongioletti F, Micali G, Ayala F, Della Bella S, Mancuso R, Calzavara Pinton P, Tourlaki A. Diagnosis and treatment of classic and iatrogenic Kaposi's sarcoma: Italian recommendations. Ital J Dermatol Venerol 2020; 156:356-365. [PMID: 33179877 DOI: 10.23736/s2784-8671.20.06703-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Kaposi's sarcoma (KS) is a lymphangioproliferative disorder associated with Human herpesvirus 8 (HHV8) infection. Four clinical subtypes are recognized: classic, endemic, epidemic (HIV-related) and iatrogenic. KS diagnosis is based on clinical features, histopathological assessment, and HHV8 serology. Classic KS is usually skin-limited and has a chronic course, while the iatrogenic variant may show mucosal, nodal or visceral involvement. Clinical staging is fundamental to guide the management. Localized disease may be treated with different local therapies, even if there are no randomized trials comparing these different modalities. Aggressive, disseminated KS and cases with visceral involvement usually require systemic chemotherapy, most commonly vinblastine, bleomycin or paclitaxel. Iatrogenic KS needs immunosuppression tapering/withdrawal and, if possible, switch to m-TOR inhibitors in post-transplant KS. The present work by a panel of Italian experts provides guidelines on KS diagnosis and management based on a critical review of the literature and a long and extensive personal experience.
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Affiliation(s)
- Lucia Brambilla
- Unit of Dermatology, Maggiore Polyclinic Hospital, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Genovese
- Unit of Dermatology, Maggiore Polyclinic Hospital, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Medical-Surgical Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Emilio Berti
- Unit of Dermatology, Maggiore Polyclinic Hospital, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Medical-Surgical Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Ketty Peris
- Unit of Dermatology, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy.,Unit of Dermatology, Sacred Heart Catholic University, Rome, Italy
| | - Franco Rongioletti
- Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giuseppe Micali
- Clinic of Dermatology, University of Catania, Catania, Italy
| | - Fabio Ayala
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Silvia Della Bella
- Unit of Clinical and Experimental Immunology, IRCCS Humanitas Clinic, Rozzano, Milan, Italy.,Department of Medical Biotechnologies and Translational Medicine, University of Milan, Milan, Italy
| | | | | | - Athanasia Tourlaki
- Unit of Dermatology, Maggiore Polyclinic Hospital, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy -
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Electrochemotherapy for the palliative management of cutaneous metastases: A systematic review and meta-analysis. Eur J Surg Oncol 2019; 45:2257-2267. [DOI: 10.1016/j.ejso.2019.07.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/21/2019] [Accepted: 07/02/2019] [Indexed: 12/21/2022] Open
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Wolff CM, Steuer A, Stoffels I, von Woedtke T, Weltmann KD, Bekeschus S, Kolb JF. Combination of cold plasma and pulsed electric fields – A rationale for cancer patients in palliative care. CLINICAL PLASMA MEDICINE 2019. [DOI: 10.1016/j.cpme.2020.100096] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Colafigli M, Ciccullo A, Borghetti A, Fanti I, Melis F, Modica S, Uccella I, Bonadies A, Ferraresi V, Anzalone E, Pennica A, Migliano E, Rossetti B, Madeddu G, Cauda R, Cristaudo A, Di Giambenedetto S, Latini A. Impact of Antiretroviral Therapy on the Risk of Recurrence in HIV-1 Infected Patients with Kaposi Sarcoma: A Multicenter Cohort Experience. J Clin Med 2019; 8:jcm8122062. [PMID: 31771172 PMCID: PMC6947508 DOI: 10.3390/jcm8122062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 11/19/2019] [Accepted: 11/21/2019] [Indexed: 12/17/2022] Open
Abstract
Kaposi sarcoma (KS) remains a relevant malignancy in human immunodeficiency virus (HIV)-infected patients with a non-standardized management; despite past suggestions that ritonavir-boosted protease inhibitor (bPI)-based regimens could be preferable, no combination antiretroviral therapy (cART) regimen was demonstrated to outperform the others and the impact of new drugs, drug classes or paradigms was never investigated nor proven better than previous therapeutic regimes. In order to do this, we retrospectively collected data regarding HIV-infected patients with a diagnosis of KS last seen in six Italian centers after 1 January 2013. A total of 104 KS cases in 99 patients was analyzed for 945.34 patient-year follow-up (PYFU). Twenty-six patients had visceral localizations. Thirty-three patients were treated with chemotherapy, four with electrochemotherapy, and 12 with α-interferon (α-IFN). At censor, 22% received a bPI-based, 14% a non-nucleoside reverse transcriptase inhibitor (NNRTI)-based, and 28% an integrase inhibitor (INI)-based standard cART, 24% a less drug regimen and 12% a mega-cART. Twelve recurrence episodes were observed in seven patients for an incidence of 1.27 per 100 PYFU. Two patients with no evidence of recurrence episodes died for other reasons. In our experience, KS recurrence episodes were infrequent. Despite the increasing use of new antiretroviral drug classes and new treatment paradigms, no excess of recurrence episodes was observed in patients receiving such cART regimens.
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Affiliation(s)
- Manuela Colafigli
- Infectious Dermatology and Allergology, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy
- Correspondence ; Tel.: +39-0652662808
| | - Arturo Ciccullo
- Clinical Infectious Diseases, Catholic University of S. Heart, 00168 Rome, Italy
| | - Alberto Borghetti
- Clinical Infectious Diseases, Catholic University of S. Heart, 00168 Rome, Italy
| | - Iuri Fanti
- Clinical Infectious Diseases, Catholic University of S. Heart, 00168 Rome, Italy
| | - Federico Melis
- Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari Italy
| | - Sara Modica
- Department of Medical Biotechnologies, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy
- Infectious Diseases Unit, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy
| | | | - Antonio Bonadies
- Plastic Surgery, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy
| | - Virginia Ferraresi
- First Division of Medical Oncology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | | | | | - Emilia Migliano
- Plastic Surgery, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy
| | - Barbara Rossetti
- Infectious Diseases Unit, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy
| | - Giordano Madeddu
- Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari Italy
| | - Roberto Cauda
- Clinical Infectious Diseases, Catholic University of S. Heart, 00168 Rome, Italy
| | - Antonio Cristaudo
- Infectious Dermatology and Allergology, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy
| | | | - Alessandra Latini
- Infectious Dermatology and Allergology, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy
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Lebbe C, Garbe C, Stratigos AJ, Harwood C, Peris K, Marmol VD, Malvehy J, Zalaudek I, Hoeller C, Dummer R, Forsea AM, Kandolf-Sekulovic L, Olah J, Arenberger P, Bylaite-Bucinskiene M, Vieira R, Middleton M, Levy A, Eggermont AM, Battistella M, Spano JP, Grob JJ, Pages C. Diagnosis and treatment of Kaposi's sarcoma: European consensus-based interdisciplinary guideline (EDF/EADO/EORTC). Eur J Cancer 2019; 114:117-127. [DOI: 10.1016/j.ejca.2018.12.036] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 12/27/2018] [Indexed: 01/28/2023]
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13
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Odyakmaz Demirsoy E, Bayramgürler D, Çağlayan Ç, Bilen N, Şikar Aktürk A, Kıran R. Imiquimod 5% Cream Versus Cryotherapy in Classic Kaposi Sarcoma. J Cutan Med Surg 2019; 23:488-495. [PMID: 31072133 DOI: 10.1177/1203475419847954] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Classic Kaposi sarcoma usually remains on the skin and has a slow progression; thus, local treatment methods are preferable. Imiquimod is an immunomodulatory agent with antiviral, antitumoural, and antiangiogenic properties that is expedient against Kaposi sarcoma. OBJECTIVES We aimed to clarify whether imiquimod is effective on classic Kaposi sarcoma lesions by comparing imiquimod treatment with cryotherapy, which is the most-used treatment method in our department for this disease. METHOD Patients with classic Kaposi sarcoma were included. All lesions of each patient were evaluated and measured by the blinded investigator considering infiltration and surface diameters. Then, lesions were categorized into 2 groups by the other investigator (nonblinded), and imiquimod 5% cream was administered 3 times per week without occlusion in 1 group. Cryotherapy was performed every 3 weeks in the other group. All lesions were reevaluated and measured at the end of 12 weeks by the blinded investigator. Initial and last measurements were compared between the treatment methods. RESULTS Fifty lesions of 8 patients were included in this study. Imiquimod and cryotherapy were applied to 26 and 24 lesions, respectively. At the end of the study, statistically significant decreases were detected in all scores between weeks 0 and 12 with both treatment methods. Mean percentages of change in scores were not significantly different between the methods. CONCLUSIONS Based on a limited number of patients and lesions treated, we believe imiquimod may be a suitable option to use for the treatment of classic Kaposi sarcoma.
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Affiliation(s)
| | - Dilek Bayramgürler
- 1 Department of Dermatology, Kocaeli University School of Medicine, Turkey
| | - Çiğdem Çağlayan
- 2 Department of Public Health, Kocaeli University School of Medicine, Turkey
| | - Nilgün Bilen
- 1 Department of Dermatology, Kocaeli University School of Medicine, Turkey
| | - Aysun Şikar Aktürk
- 1 Department of Dermatology, Kocaeli University School of Medicine, Turkey
| | - Rebiay Kıran
- 1 Department of Dermatology, Kocaeli University School of Medicine, Turkey
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14
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Campana LG, Miklavčič D, Bertino G, Marconato R, Valpione S, Imarisio I, Dieci MV, Granziera E, Cemazar M, Alaibac M, Sersa G. Electrochemotherapy of superficial tumors - Current status:: Basic principles, operating procedures, shared indications, and emerging applications. Semin Oncol 2019; 46:173-191. [PMID: 31122761 DOI: 10.1053/j.seminoncol.2019.04.002] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 04/19/2019] [Accepted: 04/24/2019] [Indexed: 12/18/2022]
Abstract
Treatment 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.
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Affiliation(s)
- Luca G Campana
- Department of Surgery Oncology and Gastroenterology (DISCOG), University of Padua, Italy; Surgical Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.
| | - Damijan Miklavčič
- University of Ljubljana, Faculty of Electrical Engineering, Ljubljana, Slovenia
| | - Giulia Bertino
- Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | | | | | - Ilaria Imarisio
- Medical Oncology Unit, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Maria Vittoria Dieci
- Surgical Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy; Medical Oncology-2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Elisa Granziera
- Anesthesiology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Maja Cemazar
- Department of Experimental Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Mauro Alaibac
- Dermatology, Department of Medicine, University of Padua, Padua, Italy
| | - Gregor Sersa
- Department of Experimental Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
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Zhang D, Hu J, Yang XY, Wu Y, Su W, Zhang CY. Target-initiated synthesis of fluorescent copper nanoparticles for the sensitive and label-free detection of bleomycin. NANOSCALE 2018; 10:11134-11142. [PMID: 29873380 DOI: 10.1039/c8nr02780c] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Fluorescent copper nanoparticles (CuNPs) have received great attention due to their distinct characteristics of facile synthesis, tunable fluorescence emission, high photostability, and biological compatibility, and they have been widely used for chemical and biological analyses. Bleomycins (BLMs) are widely used antitumor agents for the clinical treatment of various cancers. Here, we develop a sensitive and label-free fluorescence method for the quantitative detection of BLM on the basis of BLM-initiated enzymatic polymerization-mediated synthesis of fluorescent CuNPs. We design two hairpin DNAs: one (Hp1) for the recognition of BLM and the other (Hp2) for signal amplification. In the presence of BLM, it may recognize and cleave the 5'-GC-3' site of the Hp1 stem, releasing the 8-17 DNAzyme fragment. The resultant 8-17 DNAzyme fragments may bind with the loop of Hp2 to form a partial double-stranded DNA (dsDNA) duplex, initiating the cyclic cleavage of Hp2 in the presence of Zn2+-dependent DNAzymes and generating numerous new DNA fragments with the free 3'-OH terminal, which can induce the formation of a poly(thymine) (poly-T) sequence with the assistance of terminal deoxynucleotidyl transferase (TdTase). Subsequently, the ploy-T sequence may function as the template for the synthesis of CuNPs with strong fluorescence emission. This method shows good selectivity and high sensitivity with a detection limit as low as 8.1 × 10-16 M, and it exhibits good performance in serum samples. Moreover, this method has distinct advantages of simplicity and low cost, holding great potential in clinical diagnosis and biomedical research.
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Affiliation(s)
- Dandan Zhang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Shandong Provincial Key Laboratory of Clean Production of Fine Chemicals, Shandong Normal University, Jinan 250014, China.
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Kaposi's Sarcoma-Associated Herpesvirus Utilizes and Manipulates RNA N 6-Adenosine Methylation To Promote Lytic Replication. J Virol 2017; 91:JVI.00466-17. [PMID: 28592530 DOI: 10.1128/jvi.00466-17] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 05/26/2017] [Indexed: 12/20/2022] Open
Abstract
N6-adenosine methylation (m6A) is the most common posttranscriptional RNA modification in mammalian cells. We found that most transcripts encoded by the Kaposi's sarcoma-associated herpesvirus (KSHV) genome undergo m6A modification. The levels of m6A-modified mRNAs increased substantially upon stimulation for lytic replication. The blockage of m6A inhibited splicing of the pre-mRNA encoding the replication transcription activator (RTA), a key KSHV lytic switch protein, and halted viral lytic replication. We identified several m6A sites in RTA pre-mRNA crucial for splicing through interactions with YTH domain containing 1 (YTHDC1), an m6A nuclear reader protein, in conjunction with serine/arginine-rich splicing factor 3 (SRSF3) and SRSF10. Interestingly, RTA induced m6A and enhanced its own pre-mRNA splicing. Our results not only demonstrate an essential role of m6A in regulating RTA pre-mRNA splicing but also suggest that KSHV has evolved a mechanism to manipulate the host m6A machinery to its advantage in promoting lytic replication.IMPORTANCE KSHV productive lytic replication plays a pivotal role in the initiation and progression of Kaposi's sarcoma tumors. Previous studies suggested that the KSHV switch from latency to lytic replication is primarily controlled at the chromatin level through histone and DNA modifications. The present work reports for the first time that KSHV genome-encoded mRNAs undergo m6A modification, which represents a new mechanism at the posttranscriptional level in the control of viral replication.
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Di Domenico EG, Toma L, Bordignon V, Trento E, D'Agosto G, Cordiali-Fei P, Ensoli F. Activation of DNA Damage Response Induced by the Kaposi's Sarcoma-Associated Herpes Virus. Int J Mol Sci 2016; 17:ijms17060854. [PMID: 27258263 PMCID: PMC4926388 DOI: 10.3390/ijms17060854] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 05/23/2016] [Accepted: 05/27/2016] [Indexed: 01/24/2023] Open
Abstract
The human herpes virus 8 (HHV-8), also known as Kaposi sarcoma-associated herpes virus (KSHV), can infect endothelial cells often leading to cell transformation and to the development of tumors, namely Kaposi’s sarcoma (KS), primary effusion lymphoma (PEL), and the plasmablastic variant of multicentric Castleman’s disease. KSHV is prevalent in areas such as sub-Saharan Africa and the Mediterranean region presenting distinct genotypes, which appear to be associated with differences in disease manifestation, according to geographical areas. In infected cells, KSHV persists in a latent episomal form. However, in a limited number of cells, it undergoes spontaneous lytic reactivation to ensure the production of new virions. During both the latent and the lytic cycle, KSHV is programmed to express genes which selectively modulate the DNA damage response (DDR) through the activation of the ataxia telangiectasia mutated (ATM) pathway and by phosphorylating factors associated with the DDR, including the major tumor suppressor protein p53 tumor suppressor p53. This review will focus on the interplay between the KSHV and the DDR response pathway throughout the viral lifecycle, exploring the putative molecular mechanism/s that may contribute to malignant transformation of host cells.
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Affiliation(s)
- Enea Gino Di Domenico
- Clinical Pathology and Microbiology Department, San Gallicano Institute, IRCCS, Rome 00144, Italy.
| | - Luigi Toma
- Infectious Disease Consultant, San Gallicano Institute, IRCCS, Rome 00144, Italy.
| | - Valentina Bordignon
- Clinical Pathology and Microbiology Department, San Gallicano Institute, IRCCS, Rome 00144, Italy.
| | - Elisabetta Trento
- Clinical Pathology and Microbiology Department, San Gallicano Institute, IRCCS, Rome 00144, Italy.
| | - Giovanna D'Agosto
- Clinical Pathology and Microbiology Department, San Gallicano Institute, IRCCS, Rome 00144, Italy.
| | - Paola Cordiali-Fei
- Clinical Pathology and Microbiology Department, San Gallicano Institute, IRCCS, Rome 00144, Italy.
| | - Fabrizio Ensoli
- Clinical Pathology and Microbiology Department, San Gallicano Institute, IRCCS, Rome 00144, Italy.
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Campana LG, Clover AJP, Valpione S, Quaglino P, Gehl J, Kunte C, Snoj M, Cemazar M, Rossi CR, Miklavcic D, Sersa G. Recommendations for improving the quality of reporting clinical electrochemotherapy studies based on qualitative systematic review. Radiol Oncol 2016; 50:1-13. [PMID: 27069444 PMCID: PMC4825335 DOI: 10.1515/raon-2016-0006] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 01/11/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Electrochemotherapy is becoming a well-established treatment for malignancies of skin and non-skin origin and its use is widening across Europe. The technique was developed and optimized from solid experimental and clinical evidence. A consensus document is now warranted to formalize reporting results, which should strengthen evidence-based practice recommendations. This consensus should be derived from high quality clinical data collection, clinical expertise and summarizing patient feedback. The first step, which is addressed in this paper, aims to critically analyze the quality of published studies and to provide the recommendations for reporting clinical trials on electrochemotherapy. METHODS The quality of reporting in published studies on electrochemotherapy was analyzed in order to produce procedure specific reporting recommendations. A comprehensive literature search of studies published from 2006 to 2015 was performed followed by qualitative analysis of manuscripts assessing for 47 quality criteria grouped into four major clusters: (1) trial design, (2) description of patient population, (3) description of treatment delivery and patient outcome, (4) analysis of results and their interpretation. The summary measure during literature assessment was the proportion of studies fulfilling each manuscript quality criteria. RESULTS A total of 56 studies were screened, from the period 2006 to 2015, of which 33 were included in the qualitative analysis, with a total of 1215 patients. Overall, the quality of reporting was highly variable. Twenty-four reports (73%) were single-center, non-comparative studies, and only 15 (45%) were prospective in nature (only 2 of them were entered into a clinical trials registry). Electrochemotherapy technique was consistently reported, with most studies (31/33) adhering closely to published standard operating procedures. The quality of reporting the patient population was variable among the analyzed studies, with only between 45% and 100% achieving dedicated quality criteria. Reporting of treatment delivery and patient outcome was also highly variable with studies only fulfilling between 3% and 100%. Finally, reporting study results critically varied, fulfilling from 27% to 100% of the quality criteria. Based on the critical issues emerging from this analysis, recommendations and minimal requirements for reporting clinical data on electrochemotherapy were prepared and summarized into a checklist. CONCLUSIONS There is an increasing body of published clinical data on electrochemotherapy, but more high quality clinical data are needed. Published papers often lack accurate description of study population, treatment delivery as well as patient outcome. Our recommendations, provided in the form of a summary checklist, are intended to ameliorate data reporting in future studies on electrochemotherapy and help researchers to provide a solid evidence basis for clinical practice.
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Affiliation(s)
| | - A. James P. Clover
- Department of Plastic Surgery, Cork University Hospital and Cork Cancer Research Centre, University College Cork, Cork, Ireland
| | | | - Pietro Quaglino
- Department of Medical Sciences, Dermatologic Clinic, University of Torino, Torino, Italy
| | - Julie Gehl
- Center for Experimental Drug and Gene Electro transfer, Department of Oncology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Christian Kunte
- Department of Dermatology and Allergology, Ludwig-Maximilian University Munich, Munich, Germany
| | | | - Maja Cemazar
- Department of Experimental Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | | | - Damijan Miklavcic
- University of Ljubljana, Faculty of Electrical Engineering, Ljubljana, Slovenia
| | - Gregor Sersa
- Department of Experimental Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
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Tafuto S, von Arx C, De Divitiis C, Maura CT, Palaia R, Albino V, Fusco R, Membrini M, Petrillo A, Granata V, Izzo F. Electrochemotherapy as a new approach on pancreatic cancer and on liver metastases. Int J Surg 2015; 21 Suppl 1:S78-82. [PMID: 26123385 DOI: 10.1016/j.ijsu.2015.04.095] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 03/27/2015] [Accepted: 04/10/2015] [Indexed: 12/21/2022]
Abstract
Electrochemotherapy is a local non-thermal treatment for cancer ablation. Currently, many studies and case report have investigated the differences in effectiveness of electrochemotherapy with respect to tumor type, chemotherapeutic drug, and route of drug administration. ESOPE trial validated standard operating procedures [SOP] for ECT using the Cliniporator device and demonstrated that ECT is a simple, highly efficacious, and cost-effective treatment of cutaneous and subcutaneous nodules from different primary tumors for cutaneous or superficial lesions. This review has the purpose to summarize current knowledge about clinical effectiveness of electrochemotherapy and future prospects regarding its use on pancreatic cancer and liver metastasis not only.
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Affiliation(s)
- Salvatore Tafuto
- Department of Abdominal Oncology, Division of Medical Oncology, NCI "Fondazione G. Pascale", Naples, Italy.
| | - Claudia von Arx
- Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy.
| | - Chiara De Divitiis
- Department of Abdominal Oncology, Division of Medical Oncology, NCI "Fondazione G. Pascale", Naples, Italy.
| | - Claire Tracey Maura
- Department of Abdominal Oncology, Division of Medical Oncology, NCI "Fondazione G. Pascale", Naples, Italy.
| | - Raffaele Palaia
- Department of Abdominal Oncology, Division of Surgical Oncology, NCI "Fondazione G. Pascale", Naples, Italy.
| | - Vittorio Albino
- Department of Abdominal Oncology, Division of Surgical Oncology, NCI "Fondazione G. Pascale", Naples, Italy.
| | - Roberta Fusco
- Department of Diagnostic Imaging, NCI of Naples, "Fondazione G. Pascale", Naples, Italy.
| | - Massimo Membrini
- Department of Abdominal Oncology, Division of Medical Oncology, NCI "Fondazione G. Pascale", Naples, Italy.
| | - Antonella Petrillo
- Department of Diagnostic Imaging, NCI of Naples, "Fondazione G. Pascale", Naples, Italy.
| | - Vincenza Granata
- Department of Diagnostic Imaging, NCI of Naples, "Fondazione G. Pascale", Naples, Italy.
| | - Francesco Izzo
- Department of Abdominal Oncology, Division of Surgical Oncology, NCI "Fondazione G. Pascale", Naples, Italy.
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Cadossi R, Ronchetti M, Cadossi M. Locally enhanced chemotherapy by electroporation: clinical experiences and perspective of use of electrochemotherapy. Future Oncol 2014; 10:877-90. [PMID: 24799067 DOI: 10.2217/fon.13.235] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Electroporation is used to enhance drug diffusion and gene delivery into the cytosol. The combination of electroporation and cytotoxic drugs, electrochemotherapy (ECT), is used to treat metastatic tumor nodules located at the skin and subcutaneous tissue. The objective response rate following a single session of treatment exceeds 80%, with minimal toxicity for the patients. The efficacy of ECT in the bone and visceral metastasis is currently investigated, and Phase II studies have been completed. ECT has been used to treat skin primary tumors, except melanoma, and is under investigation for locally advanced pancreatic cancer. Early evidence suggests that treatment of tumor nodules with ECT recruits components of the immune system and eliciting a systemic immune response against cancer is a challenging clinical perspective. Considering the proven safety in several different clinical applications electroporation should be viewed as a clinical platform technology with wide perspectives for use in ECT, gene therapy and DNA vaccination.
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Affiliation(s)
- Ruggero Cadossi
- Clinical Research, IGEA SpA, Via Parmenide 10/A, Carpi, Italy
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21
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Campana LG, Bianchi G, Mocellin S, Valpione S, Campanacci L, Brunello A, Donati D, Sieni E, Rossi CR. Electrochemotherapy treatment of locally advanced and metastatic soft tissue sarcomas: results of a non-comparative phase II study. World J Surg 2014; 38:813-22. [PMID: 24170155 DOI: 10.1007/s00268-013-2321-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
AIMS Our aim was to evaluate the activity, toxicity, and feasibility of electrochemotherapy (ECT) in patients with soft-tissue sarcomas (STS). METHODS A two-stage phase II trial was conducted between October 2006 and March 2012. Patients (N = 34) with locally advanced or metastatic STS, unsuitable for standard oncological treatments and with maximum 3-cm deep tumors, received an intravenous bolus of bleomycin (15,000 IU/m(2)), followed by tumor electroporation according to the European Standard Operating Procedures of ECT. Outcome measures included local response according to response evaluation criteria in solid tumors (RECIST), toxicity and tumor control. Feasibility measures included the accuracy of electrode placement and the intensity of electric current flowing in tumor tissue. RESULTS Median tumor size was 4.0 cm (range 2-12). Objective response, assessed on 71 target lesions, was 92.2 % (complete 32.3, 95 % CI 28-64). A total of 15 patients received up to four cycles due to incomplete response, but re-treatment did not significantly improve outcome (p = 0.205). After a median follow-up of 19.3 months, 2-year local control rate was 72.5 %. Median time to local failure (N = 11 patients) was 5.1 months. Tumor response (p = 0.041) and control (p = 0.047) correlated with histological grading. Relevant toxicity consisted of G3 skin ulceration and soft tissue necrosis (35 and 23 % of patients, respectively), although this was manageable on an outpatient basis. The accuracy of electrode placement was 47.1 %, and the adequacy of electroporative current 85.3 %. CONCLUSIONS ECT may represent an active and safe treatment to achieve local control in advanced STS patients with symptomatic disease. Future research challenges include the improvement of electrode placement and voltage delivery together with the containment of soft tissue toxicity.
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Affiliation(s)
- Luca G Campana
- Sarcoma and Melanoma Unit, Veneto Institute of Oncology (IOV-IRCCS), Via Gattamelata-64, 35128, Padua, Italy,
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Tafuto S, von Arx C, De Divitiis C, Tracey MC, Granata V, Palaia R, Albino V, Leongito M, Izzo F. Electrochemotherapy. Front Oncol 2014. [DOI: 10.3389/fonc.2014.00115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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23
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Edhemovic I, Brecelj E, Gasljevic G, Marolt Music M, Gorjup V, Mali B, Jarm T, Kos B, Pavliha D, Grcar Kuzmanov B, Cemazar M, Snoj M, Miklavcic D, Gadzijev EM, Sersa G. Intraoperative electrochemotherapy of colorectal liver metastases. J Surg Oncol 2014; 110:320-7. [PMID: 24782355 DOI: 10.1002/jso.23625] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 03/31/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Electrochemotherapy is effective in treatment of various cutaneous tumors and could be translated into treatment of deep-seated tumors. With this aim a prospective pilot study was conducted to evaluate feasibility, safety, and efficacy of intraoperative electrochemotherapy in the treatment of colorectal liver metastases. METHODS Electrochemotherapy with bleomycin was performed during open surgery, by insertion of long needle electrodes into and around the tumor according to the individualized pretreatment plan. RESULTS A 29 metastases in 16 patients were treated in 16 electrochemotherapy sessions. No immediate (intraoperative) and/or postoperative serious adverse events related to electrochemotherapy were observed. Radiological evaluation of all the treated metastases showed 85% complete responses and 15% partial responses. In a group of seven patients that underwent a second operation at 6-12 weeks after the first one, during which electrochemotherapy was performed, the histology of resected metastases treated by electrochemotherapy showed less viable tissue (P = 0.001) compared to non-treated ones. CONCLUSIONS Electrochemotherapy of colorectal liver metastases proved to be feasible, safe, and efficient treatment modality, providing its specific place in difficult to treat metastases, located in the vicinity of major hepatic vessels, not amenable to surgery or radiofrequency ablation.
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Local intense cellular electric fields and their relevance in the computational modeling of biochemical reactions. Future Med Chem 2012; 4:1873-5. [DOI: 10.4155/fmc.12.143] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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