Application of electrochemotherapy in the management of primary and metastatic cutaneous malignant tumours: a systematic review and meta-analysis

Abstract

Application of electrochemotherapy in the management of primary and metastatic cutaneous malignant tumours: a systematic review and meta-analysis Electrochemotherapy is becoming a promising technique for the management of malignancies of skin and non-skin origin. The current review aims to clarify current knowledge on administration of electrochemotherapy for the treatment of various skin tumours. A systematic literature search was performed, up to the end of 2016, on studies in which the application of electrochemotherapy for management of primary and metastatic cutaneous malignant tumours was assessed. Having selected appropriate studies, pooled estimates of mean objective (complete) responses, with 95% confidence intervals (CIs), were calculated to assess treatment efficacy. Finally, the main emerging themes from the papers were discussed in more detail. From 465 records identified through database searching, a total of 128 studies were screened, of which 70 were included for review. After a pooled analysis, the estimate for mean objective response following electrochemotherapy was 84.02% (95% CI: 80.08-87.61). Furthermore, the pooled estimate of objective treatment response of evaluated studies was 83.91% (95% CI: 79.15-88.17%) for bleomycin and 80.82% (95% CI: 66.00-92.36%) for cisplatin. Electrochemotherapy is a feasible, inexpensive, fast and easy technique to perform local treatment, regardless of tumour type, with a low level of adverse effects and patient discomfort. This method can be applied alone for patients with primary cutaneous lesions, or local or locoregional metastases, or as an additional treatment modality in patients with distant metastases.

Palliative Electrochemotherapy in Vulvar Carcinoma: Preliminary Results of the ELECHTRA (Electrochemotherapy Vulvar Cancer) Multicenter Study

“…These results, within the limitation of some small subgroups in patients’ analyses, seems to confirm previous observations of a tumor response not related to tumor histology, as reported in literature for other tumors. In fact, several analyses reported that ECT is equally effective in basal cell carcinoma, malignant melanoma, skin recurrences from breast cancer, squamous cell carcinoma, Kaposi’s sarcoma, Merkel cell carcinoma, and other tumors [11].…”

“…BLM is a water-soluble antibiotic causing toxicity to mammalian cells by means of single- and double-stranded breaks in DNA that ultimately lead to cell death. Electro-permeabilization of cells allows the entry of the drug in the cytosol causing the damage despite low blood concentration [11,25,26]. ECT with CDDP has achieved efficacy for palliative treatment of malignant melanoma [27,28], squamous cell carcinoma [29], basal cell carcinoma [29], and cutaneous lesions of breast cancer [30].…”

“…The procedure has gradually become widespread in many European centers (about 150). Several studies have confirmed ECT efficacy in superficial skin tumors and have suggested a possible role in the treatment of mucosal and deep-seated tumors of various histological types [9,10,11,12,13].…”

Electronic Pneumatic Injection‐Assisted Dermal Drug Delivery Visualized by Ex Vivo Confocal Microscopy

“…To overcome these restraints, other physical delivery techniques have been developed to provide effective intradermal drug delivery [2]. These techniques include laser‐assisted drug delivery, microneedling, electrochemotherapy, iontophoresis, and jet injectors [3–7].…”

In Vivo Electroporation-Mediated, Intrahepatic Alpha1 Antitrypsin Gene Transfer Reduces Pulmonary Emphysema in Pallid Mice

“…In vivo electroporation-mediated gene transfer is based on the application of short electric pulses. This method has been shown to be effective in various disease models [ 8 , 9 , 10 , 11 ] and has recently been applied in clinical practice [ 12 ]. While the main source of native AAT is the liver, most other studies have focused on gene delivery for systemic distribution (e.g., muscle tissue) or in a lung-directed manner [ 7 ].…”