Electrochemotherapy as “new standard of care” treatment for cutaneous Kaposi's sarcoma

Monta, Gianluca Di; Caracò, Corrado; Benedetto, Lucia; Padula, Simone La; Marone, Ugo; Tornesello, Maria Lina; Buonaguro, Franco M.; Simeone, Ester; Ascierto, Paolo A.; Mozzillo, Nicola

doi:10.1016/j.ejso.2013.09.002

Cited by 46 publications

(44 citation statements)

References 26 publications

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“…The majority of patients (74.1%) were above 65 years while 25.9% were below 65 years of age. All patients received single or multiple ECT treatments as previously described [10], and after 24 months a clinical response was obtained in all of them according to RECIST guidelines. In particular, a complete response was observed in 20 out of 27 patients (74.1%) after a single ECT session, in three patients (11.1%) after two treatments and four patients (14.9%) after three to six ECT applications.…”

Section: Resultsmentioning

confidence: 99%

“…The ECT treatment regimen was previously described [10]. The treatment was repeated in patients who presented multiple lesions, difficult to treat in a single session or if a complete response was not achieved at a first ECT application.…”

Section: Methodsmentioning

confidence: 99%

“…Different therapeutic options are available depending on disease stage such as lesion excision, laser treatment, cryosurgery, radiotherapy and intra-lesion injection of cytotoxic drugs [8, 9]. More recently electrochemotherapy (ECT) has shown to be an effective local treatment for KS lesions [10]. ECT is a technique combining the high intensity electric pulses with the administration of non permeant or poorly permeant chemotherapeutic agents, such as bleomycin or cisplatin, to facilitate drug delivery into the tumour cells [11, 12].…”

Section: Introductionmentioning

confidence: 99%

“…ECT is a technique combining the high intensity electric pulses with the administration of non permeant or poorly permeant chemotherapeutic agents, such as bleomycin or cisplatin, to facilitate drug delivery into the tumour cells [11, 12]. ECT has shown to be very effective for the local treatment of cutaneous metastatic nodules and primary skin tumours including cutaneous KS [10, 13, 14]. …”

Section: Introductionmentioning

confidence: 99%

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Effect of electrochemotherapy on human herpesvirus 8 kinetics in classic Kaposi sarcoma

Starita

Monta

Cerasuolo

et al. 2017

Infect Agents Cancer

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BackgroundElectrochemotherapy (ECT) has shown to be an effective treatment for cutaneous and subcutaneous Kaposi sarcoma (KS) lesions. However, no study has investigated the impact of ECT treatment on the kinetics of human herpesvirus type 8 (HHV8), which is considered the necessary causal agent of KS. We aimed to evaluate HHV8 viral load and expression levels in patients affected by classic KS who received one or more ECT treatments and have been followed semi annually for up to four years.MethodsA total of 27 classic KS patients were enrolled in this study. Tumour biopsies and blood samples were obtained before ECT treatment. Additional blood samples were collected at six month intervals for 12–48 months. HHV8 viral load and expression profiles of latent (ORF72 and ORF73) and lytic (K2, K8, K8.1, K10/K10.1, K10.5/K10.6 and ORF16) genes were assessed in all samples by real-time PCR. HHV8 ORF26 and K1 regions were amplified and subjected to direct nucleotide sequencing followed by phylogenetic analysis for variant identification.ResultsAll KS biopsies and 46.4% of peripheral blood mononuclear cells (PBMCs) collected before ECT treatment were positive for HHV8 DNA. Viral load ranged from 0.02 to 2.3 copies per cell in KS lesions and 3.0 × 10−7 to 6.9 × 10−4 copies per cell in PBMCs. Overall, latent ORF72 and ORF73 as well as lytic K2, K8 and K10/K10.1 were expressed in all KS biopsies. ORF16 mRNA was detected in 71.4% and both K8.1 and K10.5/K10.6 mRNAs in 57.1% of KS samples. The ORF72, ORF73 and K2 transcripts were amplified in 37.5%, 25% and 25% of PBMCs collected before ECT, respectively. After the first ECT session, complete response was achieved in 20 out of 27 (74.1%) patients and HHV8 DNA was detected in four out of 27 (14.8%) PBMC samples at six month follow up. Phylogenetic analysis of ORF26 amplimers showed that most viral variants belonged to A/C (82.3%), and few to C2 (5.9%) or C3 (11.8%) subtype. The K1/VR1 variants fell into A (33.3%) and C (66.7%) HHV8 clade. No correlation was found between HHV8 subtypes and ECT complete response.ConclusionsECT therapy has a significant effect on HHV8 kinetics in patients with classic KS. The complete remission of patients was accompanied by clearance of circulating virus.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of electrochemotherapy on human herpesvirus 8 kinetics in classic Kaposi sarcoma

Starita

Monta

Cerasuolo

et al. 2017

Infect Agents Cancer

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“…Electrochemotherapy is a recent therapeutic method used in primary and metastatic skin tumors. It is a safe procedure that can be considered especially when multiple lesions are present [1]. Application of high intensity electric pulses temporaly increase the permeability of cell membrane, thus allowing the direct diffusion of higly cytotoxic but not permeable molecule to entry within cells [2–6].…”

Section: Introductionmentioning

confidence: 99%

Electrochemotherapy efficacy evaluation for treatment of locally advanced stage III cutaneous squamous cell carcinoma: a 22-cases retrospective analysis

et al. 2017

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BackgroundExtensive squamous cell carcinoma has few therapeutic options. In such cases, electrochemotherapy involving electroporation combined with antineoplastic drug appears to be a new potential option and may be considered as an alternative treatment. The aim of this retrospective single-center study was to evaluate electrochemotherapy efficacy in treatment of locally advanced stage III squamous cell carcinoma, in which surgical procedures would have entailed wide tissue sacrifice.MethodsClinical features, treatment response, and adverse effects were evaluated in 22 patients treated with electrochemotherapy with intravenous injection of bleomycin for extensive stage III cutaneous squamous cell carcinoma. Treatment of cutaneous lesions were performed according to the European Standard Operating Procedures of Electrochemotherapy.ResultsOverall response to electrochemotherapy treatment was observed in 18 (81.8%) patients. Clinical response with necrosis of tumor mass was observed from the first session and lasted for all follow up period that ranged between 5 and 48 months with a median of 34 months. Overall the treatment was well tolerated with a very low complication rate.ConclusionsElectrochemotherapy represents a safe and effective therapeutic approach, associated with a good tolerability.

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Mucocutaneous Manifestations in Gastrointestinal Disease

Norman¹,

Patel²,

Nguyen³

2021

Geriatric Gastroenterology

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Electrochemotherapy as “new standard of care” treatment for cutaneous Kaposi's sarcoma

Cited by 46 publications

References 26 publications

Effect of electrochemotherapy on human herpesvirus 8 kinetics in classic Kaposi sarcoma

Effect of electrochemotherapy on human herpesvirus 8 kinetics in classic Kaposi sarcoma

Electrochemotherapy efficacy evaluation for treatment of locally advanced stage III cutaneous squamous cell carcinoma: a 22-cases retrospective analysis

Mucocutaneous Manifestations in Gastrointestinal Disease

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