Electrochemotherapy, a new therapy for patients with skin cancer in Latin America: literature review

Authors

DOI:

https://doi.org/10.15343/0104-7809.202448e15462023P

Keywords:

Cancer, Dermatology, Electroporation, Surgery, Palliative

Abstract

Electrochemotherapy is an innovative technology used to treat skin and mucosal cancers. It consists of intravenous administration of bleomycin followed by the application of electroporation pulses to the tumor at its margins. These pulses induce the formation of pores in the cell membrane, increasing the cytotoxic efficacy of bleomycin by more than 1,000- fold. As electroporation is a physical phenomenon, different types of tumors can be treated regardless of their histology. Generally, only one treatment session is needed to obtain a satisfactory response. Electrochemotherapy is a good option for recurrent tumors in which other therapies do not provide a response. Additionally, tumors can be shrunk with therapy, allowing for less aggressive surgeries and improving outcomes. Many treatment guidelines have begun to include the use of this non-ablative technique as a new treatment option when other therapies have failed or been rejected by the patient. Treatment is carried out on an outpatient basis with high response rates and few side effects.

Downloads

Download data is not yet available.

References

DeVita VT Jr, Rosenberg SA, Lawrence TS. DeVita, Hellman and Rosenberg’s Cancer: Principles and Practice of Oncology [Internet]. LWW; 2022. Available from: https://books.google.com/books/about/DeVita_Hellman_and_Rosenberg_s_Cancer. html?hl=&id=opB4zgEACAAJ

Probst U, Fuhrmann I, Beyer L, Wiggermann P. Electrochemotherapy as a New Modality in Interventional Oncology: A Review. Technol Cancer Res Treat [Internet]. 2018 Jul 9 [cited 2023 Sep 27]; Available from: https://journals.sagepub.com/ doi/10.1177/1533033818785329

Marty M, Sersa G, Garbay JR, Gehl J, Collins CG, Snoj M, et al. Electrochemotherapy – An easy, highly effective and safe treatment of cutaneous and subcutaneous metastases: Results of ESOPE (European Standard Operating Procedures of Electrochemotherapy) study. Eur J Cancer Suppl [Internet]. 2006 Nov 1;4(11):3–13. Available from: http://www.sciencedirect.com/science/article/pii/ S1359634906001868

Gehl J, Sersa G, Matthiessen LW, Muir T, Soden D, Occhini A, et al. Updated standard operating procedures for electrochemotherapy of cutaneous tumours and skin metastases. Acta Oncol [Internet]. 2018 Jul 3 [cited 2023 Sep 27]; Available from: https://www. tandfonline.com/doi/abs/10.1080/0284186X.2018.1454602

Electrochemotherapy potentiation of antitumour effect of bleomycin by local electric pulses. Eur J Cancer Clin Oncol [Internet]. 1991 Jan 1 [cited 2023 Sep 27];27(1):68–72. Available from: http://dx.doi.org/10.1016/0277-5379(91)90064-K

Mir LM, Belehradek M, Domenge C, Orlowski S, Poddevin B, Belehradek J Jr, et al. [Electrochemotherapy, a new antitumor treatment: first clinical trial]. C R Acad Sci III [Internet]. 1991;313(13):613–8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/1723647

Insp-ECT [Internet]. [cited 2023 Oct 26]. Available from: https://www.insp-ect.org/

Maglietti F, Tellado M, De Robertis M, Michinski S, Fernández J, Signori E, et al. Electroporation as the Immunotherapy Strategy for Cancer in Veterinary Medicine: State of the Art in Latin America. Vaccines (Basel) [Internet]. 2020 Sep 17;8(3). Available from: http:// dx.doi.org/10.3390/vaccines8030537

Mir LM. Bases and rationale of the electrochemotherapy. Eur J Cancer Suppl [Internet]. 2006 Nov 1;4(11):38–44. Available from: http://www.sciencedirect.com/science/article/pii/S1359634906001923

Miklavcic D, Corovic S, Pucihar G, Pavselj N. Importance of tumour coverage by sufficiently high local electric field for effective electrochemotherapy. Eur J Cancer Suppl [Internet]. 2006 Nov 1;4(11):45–51. Available from: http://www.sciencedirect.com/science/ article/pii/S1359634906001935

Wichtowski M, Murawa D, Kulcenty K, Zaleska K. Electrochemotherapy in Breast Cancer - Discussion of the Method and Literature Review. Breast Care [Internet]. 2017 Dec;12(6):409–14. Available from: http://dx.doi.org/10.1159/000479954

Matthiessen LW, Muir T, Gehl J. Electrochemotherapy for larger malignant tumors. In: Clinical Aspects of Electroporation [Internet]. New York, NY: Springer New York; 2011. p. 103–13. Available from: https://link.springer.com/10.1007/978-1-4419-8363-3_9

Campana LG, Edhemovic I, Soden D, Perrone AM, Scarpa M, Campanacci L, et al. Electrochemotherapy - Emerging applications technical advances, new indications, combined approaches, and multi-institutional collaboration. Eur J Surg Oncol [Internet]. 2019 Feb;45(2):92–102. Available from: http://dx.doi.org/10.1016/j.ejso.2018.11.023

Sersa G, Cemazar M. Vascular-disrupting action of electrochemotherapy: Mode of action and therapeutic implications. In: Clinical Aspects of Electroporation [Internet]. New York, NY: Springer New York; 2011. p. 83–91. Available from: https://link.springer. com/10.1007/978-1-4419-8363-3_7

Henze J, Maintz D, Persigehl T. RECIST 1.1, irRECIST 1.1, and mRECIST: How to Do. 2016. Current Radiology Reports, 4, 1-11.

Sersa G, Teissie J, Cemazar M, Signori E, Kamensek U, Marshall G, et al. Electrochemotherapy of tumors as in situ vaccination boosted by immunogene electrotransfer. Cancer Immunol Immunother [Internet]. 2015 Oct;64(10):1315–27. Available from: http:// dx.doi.org/10.1007/s00262-015-1724-2

Tellado M, De Robertis M, Montagna D, Giovannini D, Salgado S, Michinski S, et al. Electrochemotherapy Plus IL-2+IL-12 Gene Electrotransfer in Spontaneous Inoperable Stage III-IV Canine Oral Malignant Melanoma. Vaccines (Basel) [Internet]. 2023 May 27;11(6). Available from: http://dx.doi.org/10.3390/vaccines11061033

Milicevic S, Cemazar M, Ivancic AK, Gasljevic G, Bosnjak M, Sersa G, et al. Electrochemotherapy of Melanoma Cutaneous Metastases in Organ Transplant Recipients: A Systematic Review of Preclinical and Clinical Studies. Int J Mol Sci [Internet]. 2023 May 6 [cited 2023 Oct 23];24(9):8335. Available from: https://www.mdpi.com/1422-0067/24/9/8335

Campana LG, Peric B, Mascherini M, Spina R, Kunte C, Kis E, et al. Combination of Pembrolizumab with Electrochemotherapy in Cutaneous Metastases from Melanoma: A Comparative Retrospective Study from the InspECT and Slovenian Cancer Registry. Cancers [Internet]. 2021 Aug 25;13(17). Available from: http://dx.doi.org/10.3390/cancers13174289

Clover AJP, Salwa SP, Bourke MG, McKiernan J, Forde PF, O’Sullivan ST, et al. Electrochemotherapy for the treatment of primary basal cell carcinoma; A randomised control trial comparing electrochemotherapy and surgery with five year follow up. Eur J Surg Oncol[Internet]. 2020 May;46(5):847–54. Available from: http://dx.doi.org/10.1016/j.ejso.2019.11.509

Hendel K, Jemec GBE, Haedersdal M, Wiegell SR. Electrochemotherapy with bleomycin for basal cell carcinomas: a systematic review. J Eur Acad Dermatol Venereol [Internet]. 2021 Nov;35(11):2208–15. Available from: http://dx.doi.org/10.1111/jdv.17492

Campana LG, Marconato R, Valpione S, Galuppo S, Alaibac M, Rossi CR, et al. Basal cell carcinoma: 10-year experience with electrochemotherapy. J Transl Med [Internet]. 2017 May 31;15(1):122. Available from: http://dx.doi.org/10.1186/s12967-017-1225-5

1 Recommendations | Electrochemotherapy for primary basal cell carcinoma and primary squamous cell carcinoma | Guidance | NICE. [cited 2023 Oct 26]; Available from: https://www.nice.org.uk/guidance/ipg478/chapter/1-Recommendations

Bertino G, Groselj A, Campana LG, Kunte C, Schepler H, Gehl J, et al. Electrochemotherapy for the treatment of cutaneous squamous cell carcinoma: The INSPECT experience (2008-2020). 2022. Frontiers in Oncology, 12, 951662. Available from: https://doi. org/10.3389/fonc.2022.951662

Di Monta G, Caracò C, Simeone E, Grimaldi AM, Marone U, Di Marzo M, et al. Electrochemotherapy efficacy evaluation for treatment of locally advanced stage III cutaneous squamous cell carcinoma: a 22-cases retrospective analysis. J Transl Med [Internet]. 2017 Apr 26;15(1):82. Available from: http://dx.doi.org/10.1186/s12967-017-1186-8

Overview | Electrochemotherapy for primary basal cell carcinoma and primary squamous cell carcinoma | Guidance | NICE. [cited 2023 Oct 26]; Available from: https://www.nice.org.uk/guidance/ipg478

Jamsek C, Sersa G, Bosnjak M, Groselj A. Long term response of electrochemotherapy with reduced dose of bleomycin in elderly patients with head and neck non-melanoma skin cancer. Radiol Oncol [Internet]. 2020 Mar 1 [cited 2023 Oct 17];54(1):79–85. Available from: https://sciendo.com/pdf/10.2478/raon-2020-0009

Campana LG, Testori A, Mozzillo N, Rossi CR. Treatment of metastatic melanoma with electrochemotherapy. J Surg Oncol [Internet]. 2014 Mar;109(4):301–7. Available from: http://dx.doi.org/10.1002/jso.23512

Kunte C, Letulé V, Gehl J, Dahlstroem K, Curatolo P, Rotunno R, et al. Electrochemotherapy in the treatment of metastatic malignant melanoma: a prospective cohort study by InspECT. Br J Dermatol [Internet]. 2017 Jun;176(6):1475–85. Available from: http://dx.doi. org/10.1111/bjd.15340

Petrelli F, Ghidini A, Simioni A, Campana LG. Impact of electrochemotherapy in metastatic cutaneous melanoma: a contemporary systematic review and meta-analysis. Acta Oncol [Internet]. 2022 May 4 [cited 2023 Oct 23]; Available from: https://www.tandfonline. com/doi/abs/10.1080/0284186X.2021.2006776

Recommendations | Melanoma: assessment and management | Guidance | NICE. [cited 2023 Oct 26]; Available from: https:// www.nice.org.uk/guidance/ng14/chapter/Recommendations

Michielin O, van Akkooi A, Lorigan P, Ascierto PA, Dummer R, Robert C, et al. ESMO consensus conference recommendations on the management of locoregional melanoma: under the auspices of the ESMO Guidelines Committee. Ann Oncol [Internet]. 2020 Nov;31(11):1449–61. Available from: http://dx.doi.org/10.1016/j.annonc.2020.07.005

Ferioli M, Galuppi A, Buwenge M, Cammelli S, Perrone AM, Macchia G, et al. Electrochemotherapy in Kaposi sarcoma: A systematic review. Mol Clin Oncol [Internet]. 2021 Apr;14(4):64. Available from: http://dx.doi.org/10.3892/mco.2021.2226

Manca G, Pandolfi P, Gregorelli C, Cadossi M, de Terlizzi F. Treatment of keloids and hypertrophic scars with bleomycin and electroporation. Plast Reconstr Surg [Internet]. 2013 Oct;132(4):621e – 630e. Available from: http://dx.doi.org/10.1097/ PRS.0b013e3182a053c8

Granata V, Fusco R, D’Alessio V, Simonetti I, Grassi F, Silvestro L, et al. Percutanous Electrochemotherapy (ECT) in Primary and Secondary Liver Malignancies: A Systematic Review. Diagnostics [Internet]. 2023 Jan 5 [cited 2023 Oct 1];13(2):209. Available from: https://www.mdpi.com/2075-4418/13/2/209

Izzo F, Granata V, Fusco R, D’Alessio V, Petrillo A, Lastoria S, et al. Clinical Phase I/II Study: Local Disease Control and Survival in Locally Advanced Pancreatic Cancer Treated with Electrochemotherapy. J Clin Med Res [Internet]. 2021 Mar 22;10(6). Available from: http://dx.doi.org/10.3390/jcm10061305

Deschamps F, Tselikas L, Yevich S, Bonnet B, Roux C, Kobe A, et al. Electrochemotherapy in radiotherapy-resistant epidural spinal cord compression in metastatic cancer patients. Eur J Cancer [Internet]. 2023 Jun 1 [cited 2023 Oct 27];186:62–8. Available from: http://www.ejcancer.com/article/S095980492300148X/abstract

Perrone AM, Corrado G, Coada CA, Garganese G, Fragomeni SM, Tagliaferri L, et al. Electrochemotherapy with intravenous bleomycin for heavily pre-treated vulvar cancer patients. Int J Gynecol Cancer [Internet]. 2023 Apr 1 [cited 2023 Sep 27];33(4). Available from: https://ijgc.bmj.com/content/33/4/473.abstract

Published

2024-04-05

How to Cite

Maglietti, F. H., Tellado, M., Ramallo, G. F., Martínez, N. S., Campastri, A., Cilio, A., & Acosta, A. C. (2024). Electrochemotherapy, a new therapy for patients with skin cancer in Latin America: literature review. O Mundo Da Saúde, 48. https://doi.org/10.15343/0104-7809.202448e15462023P