Bleomycin Concentration in Patients’ Plasma and Tumors after Electrochemotherapy. A Study from InspECT Group

Groselj, Aleš; Bošnjak, Maša; Kržan, Mojca; Kosjek, Tina; Bottyán, Kriszta; Plesnik, Helena; Jamsek, Crt; Čemažar, Maja; Kis, Erika; Serša, Gregor

doi:10.3390/pharmaceutics13091324

Cited by 8 publications

(5 citation statements)

References 28 publications

(40 reference statements)

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“…Therefore, the results of electroporation associated with chemotherapy combinations vary. In a study of human patients, it was observed that patients diagnosed with cutaneous angiosarcoma had the highest concentrations of BLM (819 mg/g); however, the tumor presented tumor progression and had no response to ECT [ 65 , 66 ], showing a difference in perfusion, vascularization, and response in different tumor types.…”

Section: Treatmentmentioning

confidence: 99%

Diagnosis, Prognosis, and Treatment of Canine Hemangiosarcoma: A Review Based on a Consensus Organized by the Brazilian Association of Veterinary Oncology, ABROVET

Nardi

Massoco

Fonseca-Alves

et al. 2023

Cancers

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Hemangiosarcoma is a mesenchymal neoplasm originating in the endothelial cells of blood vessels; they can be classified as non-visceral and visceral types. Non-visceral hemangiosarcomas can affect the skin, subcutaneous tissues, and muscle tissues; visceral hemangiosarcomas can affect the spleen, liver, heart, lungs, kidneys, oral cavity, bones, bladder, uterus, tongue, and retroperitoneum. Among domestic species, dogs are most affected by cutaneous HSA. Cutaneous HSA represents approximately 14% of all HSA diagnosed in this species and less than 5% of dermal tumors, according to North American studies. However, Brazilian epidemiological data demonstrate a higher prevalence, which may represent 27 to 80% of all canine HSAs and 13.9% of all skin neoplasms diagnosed in this species. Cutaneous HSA most commonly affects middle-aged to elderly dogs (between 8 and 15 years old), with no gender predisposition for either the actinic or non-actinic forms. The higher prevalence of cutaneous HSA in some canine breeds is related to lower protection from solar radiation, as low skin pigmentation and hair coverage lead to greater sun exposure. Actinic changes, such as solar dermatosis, are frequent in these patients, confirming the influence of solar radiation on the development of this neoplasm. There are multiple clinical manifestations of hemangiosarcoma in canines. The diagnostic approach and staging classification of cutaneous HSAs are similar between the different subtypes. The definitive diagnosis is obtained through histopathological analysis of incisional or excisional biopsies. Cytology can be used as a presurgical screening test; however, it has little diagnostic utility in cases of HSA because there is a high risk of blood contamination and sample hemodilution. Surgery is generally the treatment of choice for dogs with localized non-visceral HSA without evidence of metastatic disease. Recently, electrochemotherapy (ECT) has emerged as an alternative therapy for the local ablative treatment of different neoplastic types; the use of radiotherapy for the treatment of dogs with cutaneous HSA is uncommon. There is greater consensus in the literature regarding the indications for adjuvant chemotherapy in subcutaneous and muscular HSA; doxorubicin is the most frequently used antineoplastic agent for subcutaneous and muscular subtypes and can be administered alone or in combination with other drugs. Other therapies include antiangiogenic therapy, photodynamic therapy, the association of chemotherapy with the metronomic dose, targeted therapies, and natural products. The benefits of these therapies are presented and discussed. In general, the prognosis of splenic and cardiac HSA is unfavorable. As a challenging neoplasm, studies of new protocols and treatment modalities are necessary to control this aggressive disease.

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Section: Treatmentmentioning

confidence: 99%

Diagnosis, Prognosis, and Treatment of Canine Hemangiosarcoma: A Review Based on a Consensus Organized by the Brazilian Association of Veterinary Oncology, ABROVET

Nardi

Massoco

Fonseca-Alves

et al. 2023

Cancers

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“…In this context, it should be considered that the pharmacokinetic pro le of BLM in the distribution phase after bolus injection is not known in each tumor model. Preliminary data from clinical studies in cutaneous cancer concluded that a complete response in ECT-treated lesions can be achieved with a minimal intracellular concentration of 14-18 ng/g [29]. In our study, we used BLM at a dose of 4 U/kg for i.v.…”

Section: Discussionmentioning

confidence: 99%

Electrochemotherapy with intravenous, intratumoral, or combined administration of bleomycin in the treatment of colorectal hepatic metastases in a rat model

Spiliotis,

Holländer,

Wagenpfeil

et al. 2024

Preprint

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Electrochemotherapy (ECT) combines the reversible electroporation (rEP) with intravenous (i.v.) or intratumoral (i.t.) administration of chemotherapeutic drugs. We conducted this study to compare the efficacy of i.v., i.t., and i.v. + i.t. injection of bleomycin (BLM) in ECT treatment of colorectal hepatic metastases in a rat model. WAG/Rij rats were randomized into three groups and underwent ECT with i.v., i.t., or i.v. + i.t. injection of BLM. Tumor volumes and oxygenation were measured by means of ultrasound and photoacoustic imaging. Moreover, liver and tumor tissue were analyzed by histology and immunohistochemistry. The i.v. and i.v. + i.t. groups exhibited a 44.0% and 46.6% reduction in oxygen saturation of the tumor tissue when compared to pretreatment values, whereas the i.t. group only showed a reduction of 35.2%. The extent of tumor tissue necrosis did not statistically differ between the groups. However, the i.t. group showed a tendency towards a lower necrosis rate. Cell proliferation, apoptotic cell death, vascularization, and immune cell infiltration were comparable in the treated tumors of the three groups. ECT with i.v. administration of BLM should be preferred in clinical practice, as the combined i.v. + i.t. therapy did not show superior oncological outcomes in the present study.

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“…Since the patient was old with several comorbidities and BLM was injected intra-arterially, we additionally reduced the recommended dose by 40% to avoid significant necrosis of the treated area and pulmonary fibrosis. This decision was based on our previous studies on elderly patients treated with ECT in combination with a reduced dose of intravenously administered BLM ( 8 , 44 , 45 ). Another significant issue is using superselective catheterization for intraarterial BLM administration and balloon occlusion to prevent BLM washout during electroporation.…”

Section: Discussionmentioning

confidence: 99%

Combining superselective catheterization and electrochemotherapy: A new technological approach to the treatment of high-flow head and neck vascular malformations

et al. 2022

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IntroductionThe study aims to demonstrate a combination of superselective catheterization and electrochemotherapy as a feasible and effective new technological approach in treating high-flow vascular malformations of the head and neck region.Patients and methodsIn the patient with high-flow arteriovenous malformation of the lower lip, superselective catheterization was performed under general anesthesia. The microcatheter was used to administer 750 IU BLM intra-arterially into the feeding vessel. The whole malformation surface was then covered with 15 applications of electric pulses using the plate electrode.ResultsExcellent response, without functional or aesthetic deficits, was obtained in 10 weeks. During this period, debridement and necrectomy were performed regularly on follow-up visits. The pain was managed with oral paracetamol and sodium metamizole.ConclusionCombining electrochemotherapy using bleomycin with superselective catheterization and arteriography is a feasible treatment option for high-flow vascular malformations in the head and neck region and could play a significant role in managing these challenging lesions.

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Bleomycin Concentration in Patients’ Plasma and Tumors after Electrochemotherapy. A Study from InspECT Group

Cited by 8 publications

References 28 publications

Diagnosis, Prognosis, and Treatment of Canine Hemangiosarcoma: A Review Based on a Consensus Organized by the Brazilian Association of Veterinary Oncology, ABROVET

Diagnosis, Prognosis, and Treatment of Canine Hemangiosarcoma: A Review Based on a Consensus Organized by the Brazilian Association of Veterinary Oncology, ABROVET

Electrochemotherapy with intravenous, intratumoral, or combined administration of bleomycin in the treatment of colorectal hepatic metastases in a rat model

Combining superselective catheterization and electrochemotherapy: A new technological approach to the treatment of high-flow head and neck vascular malformations

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