Electrochemotherapy and Ablative Therapies in Non-melanoma Skin Cancer

O'Donoghue, N. B.; Mowatt, David; Sykes, Andrew J

doi:10.1016/j.clon.2019.08.010

Cited by 9 publications

(4 citation statements)

References 73 publications

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“…ECT allows the delivery of non-permeant chemotherapy, such as bleomycin, into cells through administration of short, intense electric pulses that increase cell membrane permeability, thereby enhancing the cytotoxic activity of chemotherapy ( 4 ). ECT, most commonly used with bleomycin, is well tolerated and has been shown to be an effective treatment strategy in several tumor types, including non-melanoma skin cancers ( 4 ). Complete responses have been reported with ECT in some patients with MCC; however, published literature remains limited ( 4 – 6 ).…”

Section: Discussionmentioning

confidence: 99%

“…ECT, most commonly used with bleomycin, is well tolerated and has been shown to be an effective treatment strategy in several tumor types, including non-melanoma skin cancers ( 4 ). Complete responses have been reported with ECT in some patients with MCC; however, published literature remains limited ( 4 – 6 ). In the case presented here, ECT was chosen due to the small area of local relapse and absence of distant lesions; previous clinical data described the efficacy of ECT in small and locally relapsed MCC lesions of head and neck origin ( 5 , 6 ).…”

Section: Discussionmentioning

confidence: 99%

“…Although MCC is considered chemo-sensitive, responses to chemotherapy are rarely durable; median overall survival with chemotherapy is approximately 10 months (1,2). Recently, emerging evidence suggests that electrochemotherapy (ECT; electrical pulses administered alongside chemotherapy) may be an effective treatment option for patients with MCC, although published literature is limited to case reports (4)(5)(6). Furthermore, immune checkpoint inhibitors (ICIs), including the anti-programmed cell death-ligand 1 (PD-L1) monoclonal antibody avelumab, are currently recommended for the treatment of patients with metastatic MCC (mMCC) based on promising results including durable responses observed in clinical trials (1,(7)(8)(9).…”

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confidence: 99%

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Case Report: Exceptional Response to Avelumab After Failure of Electrochemotherapy in a Patient With Rapidly Progressive, PD-L1-Negative Merkel Cell Carcinoma

et al. 2021

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This case report shows, for the first time, a patient experiencing a complete response after one dose of avelumab following extensive disease progression with prior electrochemotherapy (ECT) treatment. We suggest that ECT may help to establish a tumor microenvironment favorable to immunotherapy. Merkel cell carcinoma (MCC) is a highly aggressive skin cancer with seldom durable chemotherapy responses. ECT has recently emerged as a potential treatment option for several malignancies, including MCC. Avelumab, an anti-programmed cell death-ligand 1 (PD-L1) monoclonal antibody, became the first approved treatment for patients with metastatic MCC. ECT has been shown to activate the immune response, but it is still unknown how ECT may affect patient’s response to subsequent immunotherapy. We report a case of a patient with MCC who presented with a rapidly growing skin nodule of the right cheek and experienced extensive disease progression following surgical debulking and ECT treatment. The patient received a flat dose of 800 mg avelumab intravenously every 2 weeks showing complete tumor regression after only one dose. Immunohistochemical analysis of surgical and post-ECT biopsies collected from the primary lesion revealed tumor expression of programmed cell death protein-1 (PD-1), but not PD-L1. Analysis of the tumor samples also revealed no expression of Merkel cell polyomavirus (MCPyV). Comparison of the biopsies showed a decrease in myeloid and T-cell markers after ECT but an increase in major histocompatibility complex (MHC) class I expression on tumor cells. Additionally, the patient experienced an increase in neutrophil-to-lymphocyte ratio and lactate dehydrogenase values post-ECT, which subsequently decreased with avelumab treatment. As of 30 October 2019, the patient was still receiving avelumab treatment and had an ongoing complete response. In this case report, a patient with PD-L1-negative and MCPyV-negative MCC who had disease progression following ECT experienced complete tumor regression with avelumab treatment, suggesting, for the first time to our knowledge, that ECT may help to establish a tumor microenvironment favorable to immunotherapy via a potential abscopal effect. Tumor-intrinsic PD-1 expression and modulation of MHC class I antigens after ECT may contribute to the clinical efficacy of avelumab in this context.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Case Report: Exceptional Response to Avelumab After Failure of Electrochemotherapy in a Patient With Rapidly Progressive, PD-L1-Negative Merkel Cell Carcinoma

et al. 2021

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“…The data used in the assessment of PCF with the steps and results presented in Section 4 and Section 5 are the primary data collected between 2017 and 2019 from a beverage product manufacturer. The data on the input energy derived from raw material and transportation, and the output energy such as by‐product and waste were collected with reference to the developed process model (O'Donoghue et al, 2019) and international PCF standards (BSI, 2011). The raw materials include sugar, beverage bases, carton trays, wrapper, PE film, cans and pallets.…”

Section: Emission Impact Case Analysismentioning

confidence: 99%

Sustainable consumption and production: Modelling product carbon footprint of beverage merchandise using a supply chain input‐process‐output approach

Wong

et al. 2021

Corp Soc Responsibility Env

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The continuous increase in beverage consumption worldwide results in enormous energy consumption and carbon emission along the life cycle of beverage products.A novel input-process-output product carbon footprint (PCF) model is developed as a generic framework for products and services with complex operations along the supply chain. A PCF of a carbonated drink product is evaluated at each of the major stages in the product's life cycle with results compared to using GHG Protocol methodology. Results from cradle-to-grave analysis indicate retail and distribution has the largest emissions impact along the product life cycle. Retail distribution routing optimisation model is developed and retail vending equipment are analysed to explore opportunities for reducing energy consumption and carbon footprint. Future sustainable development studies on the PCF of same beverage merchandises produced in various countries and mitigation measures using dynamic routing distribution could be carried out.

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Electrochemotherapy as a Multi-Modality Component of Cancer Treatment: Combinations with Surgery, Cryosurgery, Radiation Therapy, and Chemotherapy

Tellado

Maglietti

Impellizeri³

2021

Electroporation in Veterinary Oncology Practice

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Electrochemotherapy and Ablative Therapies in Non-melanoma Skin Cancer

Cited by 9 publications

References 73 publications

Case Report: Exceptional Response to Avelumab After Failure of Electrochemotherapy in a Patient With Rapidly Progressive, PD-L1-Negative Merkel Cell Carcinoma

Case Report: Exceptional Response to Avelumab After Failure of Electrochemotherapy in a Patient With Rapidly Progressive, PD-L1-Negative Merkel Cell Carcinoma

Sustainable consumption and production: Modelling product carbon footprint of beverage merchandise using a supply chain input‐process‐output approach

Electrochemotherapy as a Multi-Modality Component of Cancer Treatment: Combinations with Surgery, Cryosurgery, Radiation Therapy, and Chemotherapy

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