Electrochemotherapy as palliative treatment in patients with advanced head and neck tumours: Outcome analysis in 93 patients treated in a single institution

Longo, Francesco; Perri, Francesco; Pavone, Ettore; Aversa, Corrado; Maglione, Maria Grazia; Guida, Agostino; Montano, Massimo; Villano, S.; Daponte, Antonio; Caponigro, Francesco; Ionna, Franco

doi:10.1016/j.oraloncology.2019.03.016

Cited by 15 publications

(23 citation statements)

References 31 publications

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“…Most publications reported on studies of prospective design, i.e., phase 2 observational studies [17][18][19][20]22,[24][25][26][27][29][30][31][33][34][35]; only three studies were retrospective [25][26][27], and one was a case report [36] (Table 1). Four studies were reported in more than one publication [15][16][17]21,23,25,28,29,32,33].…”

Section: Characteristics Of the Eligible Studiesmentioning

confidence: 99%

“…Four studies were reported in more than one publication [15][16][17]21,23,25,28,29,32,33]. Individual patient data were reported in 10 studies (86 patients, 52.4%) [17,18,20,[24][25][26]29,33,34,36] and group data in six studies (78 patients, 47.6%) [19,22,27,30,31,35]. The number of patients with mucosal HNC treated in these studies ranged from 1 to 43 patients (median 6.5; interquartile range 2.5-15.5).…”

Section: Characteristics Of the Eligible Studiesmentioning

confidence: 99%

“…The number of patients with mucosal HNC treated in these studies ranged from 1 to 43 patients (median 6.5; interquartile range 2.5-15.5). In five studies, only mucosal tumors were treated [18,29,31,34,36], whereas a combination of mucosal and cutaneous treatments was reported in 11 studies [17,19,20,22,[24][25][26][27]30,33,35].…”

Section: Characteristics Of the Eligible Studiesmentioning

confidence: 99%

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Electrochemotherapy in Mucosal Cancer of the Head and Neck: A Systematic Review

Strojan

Groselj

Serša

et al. 2021

Cancers

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Electrochemotherapy (ECT) is a local ablative treatment that is based on the reversible electroporation and intracellular accumulation of hydrophilic drug molecules, which greatly increases their cytotoxicity. In mucosal head and neck cancer (HNC), experience with ECT is limited due to the poor accessibility of tumors. In order to review the experience with ECT in mucosal HNC, we undertook a systematic review of the literature. In 22 articles, published between 1998 and 2020, 16 studies with 164 patients were described. Curative and palliative intent treatment were given to 36 (22%) and 128 patients (78%), respectively. The majority of tumors were squamous cell carcinomas (79.3%) and located in the oral cavity (62.8%). In the curative intent group, complete response after one ECT treatment was achieved in 80.5% of the patients, and in the palliative intent group, the objective (complete and partial) response rate was 73.1% (31.2% and 41.9%). No serious adverse events were reported during or soon after ECT and late effects were rare (19 events in 17 patients). The quality-of-life assessments did not show a significant deterioration at 12 months post-ECT. Provided these preliminary data are confirmed in randomized controlled trials, ECT may be an interesting treatment option in selected patients with HNC not amenable to standard local treatment.

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Section: Characteristics Of the Eligible Studiesmentioning

confidence: 99%

Section: Characteristics Of the Eligible Studiesmentioning

confidence: 99%

Section: Characteristics Of the Eligible Studiesmentioning

confidence: 99%

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Electrochemotherapy in Mucosal Cancer of the Head and Neck: A Systematic Review

Strojan

Groselj

Serša

et al. 2021

Cancers

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“…Many chemotherapeutic agents such as bleomycin or cisplatin can have off-target effects, difficulty penetrating beyond the surface of the tumor, and the potential for chemoresistance ( 70 , 71 ). Thus, ECT facilitates using local or acute systemic application of smaller doses of the chemotherapeutic, which can reduce side effects, and increases cellular uptake of the chemotherapeutics in the treatment zone ( 72 – 74 ). Cell death via ECT varies based on the chemotherapy's mechanism of action, but reversible electroporation alone does not lead to significant cell death or tumor ablation ( 75 ).…”

Section: Electroporation-based Ablation Modalitiesmentioning

confidence: 99%

Starting a Fire Without Flame: The Induction of Cell Death and Inflammation in Electroporation-Based Tumor Ablation Strategies

et al. 2020

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New therapeutic strategies and paradigms are direly needed for the treatment of cancer. While the surgical removal of tumors is favored in most cancer treatment plans, resection options are often limited based on tumor localization. Over the last two decades, multiple tumor ablation strategies have emerged as promising stand-alone or combination therapeutic options for patients. These strategies are often employed to treat tumors in areas where surgical resection is not possible or where chemotherapeutics have proven ineffective. The type of cell death induced by the ablation modality is a critical aspect of therapeutic success that can impact the efficacy of the treatment and systemic anti-tumor immune system responses. Electroporation-based ablation technologies include electrochemotherapy, irreversible electroporation, and other modalities that rely on pulsed electric fields to create pores in cell membranes. These pores can either be reversible or irreversible depending on the electric field parameters and can induce cell death either alone or in combination with a therapeutic agent. However, there have been many controversial findings among these technologies as to the cell death type initiated, from apoptosis to pyroptosis. As cell death mechanisms can impact treatment side effects and efficacy, we review the main types of cell death induced by electroporation-based treatments and summarize the impact of these mechanisms on treatment response. We also discuss potential reasons behind the variability of findings such as the similarities between cell death pathways, differences between cell-types, and the variation in electric field strength across the treatment area.

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“…Interestingly, Longo et al [ 45 ], used bleomycin-based ECT to treat 93 patients with recurrent and/or metastatic head and neck tumors, mostly constituted by SCCHN, who had progressed after at least two lines of chemotherapy. Primary endpoints were palliation of the symptoms (bleeding and pain) and improvement of quality of life; secondary endpoints were ORR and DCR.…”

Section: The Landscape Of Immuno-ect In Scchnmentioning

confidence: 99%

Boosting the Immune Response with the Combination of Electrochemotherapy and Immunotherapy: A New Weapon for Squamous Cell Carcinoma of the Head and Neck?

Longo

Perri

Caponigro

et al. 2020

Cancers

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Head and neck squamous cell carcinomas (SCCHN) are not rare malignancies and account for 7% of all solid tumors. Prognosis of SCCHN patients strongly depends on tumor extension, site of onset, and genetics. Advanced disease (recurrent/metastatic) is associated with poor prognosis, with a median overall survival of 13 months. In these patients, immunotherapy may represent an interesting option of treatment, given the good results reached by check-point inhibitors in clinical practice. Nevertheless, only a minor number of patients with advanced disease respond to immunotherapy, and, disease progressions/hyper-progressions are common. The latter could be a very difficult issue, especially in patients having a wide and highly symptomatic head/neck mass. Given the potentiality to boost the immune response of some local modalities, such as electrochemotherapy, a possible future approach may take into account the combination of electrochemotherapy and immunotherapy to treat patients affected by SCCHN, suffering from symptomatic lesions that need rapid debulking.

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Electrochemotherapy as palliative treatment in patients with advanced head and neck tumours: Outcome analysis in 93 patients treated in a single institution

Cited by 15 publications

References 31 publications

Electrochemotherapy in Mucosal Cancer of the Head and Neck: A Systematic Review

Electrochemotherapy in Mucosal Cancer of the Head and Neck: A Systematic Review

Starting a Fire Without Flame: The Induction of Cell Death and Inflammation in Electroporation-Based Tumor Ablation Strategies

Boosting the Immune Response with the Combination of Electrochemotherapy and Immunotherapy: A New Weapon for Squamous Cell Carcinoma of the Head and Neck?

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