Effective treatment of Kaposi's sarcoma by electrochemotherapy and intravenous bleomycin administration

Abstract

The present prospective study was aimed at evaluating the long-term efficacy of local electrochemotherapy (ECT) with the intravenous administration of bleomycin, on disease progression and viral activity in classic Kaposi's sarcoma (cKS), a vascular tumor related to human herpes virus-8 infection. Eighteen patients affected by isolate or multiple cutaneous lesions, refractory to conventional treatments, although in the absence of visceral involvement, were enrolled in a study. Follow-up visits were performed after 4 weeks and every 6 months for up to 48 months. A more extensive exploration of the immunologic status as well as of virological parameters was performed in nine patients. The results showed a significant clinical improvement in all patients after 4 weeks. A complete regression was observed in 12 patients after the first ECT, while four patients required a second treatment on the residual lesions after 4 weeks from the first intervention. The positive outcome persisted during the subsequent clinical control visits. Two patients, that showed rapidly evolving did not improve and relapsed despite a second round of ECT treatment. Effective treatment was associated with the reduction of viral load to undetectable levels. These data support the conduct of larger studies directed at validating the efficacy of ECT as a first-line therapy for cKS.

Intraoperative electrochemotherapy of colorectal liver metastases

“…Electrochemotherapy with bleomycin is effective in different cutaneous and subcutaneous tumors , as well as on preclinical models of colorectal tumors . To date electrochemotherapy has been shown to be very effective in treatment of superficial metastatic disease, such as melanoma and chest wall breast cancer recurrence . Its value of treating metastatic or unresectable disease within the abdomen and chest has enormous potential .…”

Electrochemotherapy

“…Twenty-five tumors were located 1 cm from the main hepatic vein and 16 lesions were sited 1 cm from the main portal vessels. Almost (98.1%) all lesions responded to ECT: of the 53 responder lesions, 6 (5.7%) recurred locally and 1 (1.9%) patient showed persistent disease after a median follow-up of 6 months (34). None of the hepatic veins within 1 cm of treated tumors was occluded on postprocedure www.frontiersin.org imaging.…”

“…In fact, the effects on eating and speech were assessed using the Performance Status Scale for Head and Neck Cancer Patients (PSS-HN) and the functional outcome was very good (34). However, these results need further verification.…”

Familial Kaposi's Sarcoma in HHV8 infected subjects presenting the G-174C allele of the IL-6 promoter: a possible role for EBV?

“…Previously suggested predisposing factors include immune suppression or an imbalanced immune response [3,4]. Consequently, the patient underwent local treatment with electrochemotherapy and intravenous administration of bleomycin [8]. Among the environmental factors, secondary infections may play a role, directly or indirectly, by a reactivation of HHV-8 [7].…”