Electrochemotherapy in Kaposi sarcoma: A systematic review

Ferioli, Martina; Galuppi, Andrea; Buwenge, M.; Cammelli, Silvia; Perrone, Anna Myriam; Macchia, G.; Deodato, Francesco; Cilla, Savino; Zamagni, Alice; Terlizzi, Francesca de; Tagliaferri, Luca; Iaco, Pierandrea De; Morganti, Alessio Giuseppe

doi:10.3892/mco.2021.2226

Cited by 10 publications

(14 citation statements)

References 19 publications

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“…1 According to previous reports, ECT showed CR in 65-100% of cases after 1-3 sessions 2,4,5,12 with an overall response rate of 100% in all studies. 12 This is in accordance with our study results. The response rate for KS could be related to the high vascularity in this tumor type.…”

Section: Discussionmentioning

confidence: 84%

Cutaneous and subcutaneous Kaposi's sarcoma lesions treated with electrochemotherapy

et al. 2022

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Background and Objectives Kaposi's sarcoma (KS) is a locally aggressive mesenchymal tumor that involves the lymphovascular system, with a tendency to become multifocal. Electrochemotherapy (ECT) is considered a valuable treatment option in selected patients with cutaneous and subcutaneous KS lesions.Methods We report a retrospective study that included 14 classic and endemic KS patients that underwent ECT sessions for the treatment of KS cutaneous and subcutaneous lesions at our institution. ResultsAccording to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria, our patients had an overall response rate (ORR) of 100% to the ECT treatment. A complete response (CR) was obtained in 92.8% of patients after one or more ECT sessions. Only one patient had a progressive disease (PD). The treatment was well tolerated with a low complication rate, mainly transitory local pain or skin ulceration.Conclusions ECT represents a locoregional therapy for containment and symptomatic control of classic and endemic KS cutaneous and subcutaneous lesions. Further studies including different subtypes of KS patients should also be performed.

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Section: Discussionmentioning

confidence: 84%

Cutaneous and subcutaneous Kaposi's sarcoma lesions treated with electrochemotherapy

et al. 2022

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“…Most frequently reported toxicities were pain and erythema which were reported as mild in most patients. Therefore, based on the available evidence, ECT can be considered well tolerated and effective in terms of tumor response in this setting, albeit with a wide variability of the reported results [ 9 , 10 , 32 , 33 ]. Finally, the pooled rates reported in this analysis can serve as a benchmark for further studies aimed at improving current outcomes by optimizing treatment techniques and patient selection, as well as improving treatments combinations.…”

Section: Discussionmentioning

confidence: 99%

“…Considering the efficacy of ECT in other skin cancers [ 5 , 9 , 10 ], and the potential advantage of the hemostatic effect produced by the vascular lock in hemorrhagic lesions, some studies tested ECT in cutaneous MM metastases [ 11 , 12 ]. However, no randomized study comparing ECT with other local therapies have been published on this topic.…”

Section: Introductionmentioning

confidence: 99%

Electrochemotherapy of skin metastases from malignant melanoma: a PRISMA-compliant systematic review

Ferioli

Lancellotta

Perrone³

et al. 2022

Clin Exp Metastasis

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The main treatment of MM metastases are systemic therapies, surgery, limb perfusion, and intralesional talimogene laherparepvec. Electrochemotherapy (ECT) is potentially useful also due to the high response rates recorded in cancers of any histology. No randomized studies comparing ECT with other local therapies have been published on this topic. We analyzed the available evidence on efficacy and toxicity of ECT in this setting. PubMed, Scopus, and Cochrane databases were screened for paper about ECT on MM skin metastases. Data about tumor response, mainly in terms of overall response rate (ORR), toxicity (both for ECT alone and in combination with systemic treatments), local control (LC), and overall survival (OS) were collected. The methodological quality was assessed using a 20-item validated quality appraisal tool for case series. Overall, 18 studies were included in our analysis. In studies reporting “per patient” tumor response the pooled complete response (CR) was 35.7% (95%CI 26.0–46.0%), and the pooled ORR was 80.6% (95%CI 68.7–90.1%). Regarding “per lesion” response, the pooled CR was 53.5% (95%CI 42.1–64.7%) and the pooled ORR was 77.0% (95%CI 56.0–92.6%). One-year LC rate was 80%, and 1-year OS was 67–86.2%. Pain (24.2–92.0%) and erythema (16.6–42.0%) were the most frequent toxicities. Two studies reported 29.2% and 41.6% incidence of necrosis. ECT is effective in terms of tumor response and tolerated in patients with skin metastases from MM, albeit with a wide variability of reported results. Therefore, prospective trials in this setting are warranted.

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“…Then, disease progression is controlled and nodules are eliminated. In recent years, for local lesions in KS, several local therapies have been developed, including radiation therapy ( 9 ), intralesional chemotherapy ( 10 ), and electrochemotherapy ( 11 ). Topical treatments of dimiquimod or topical 9- cis -retinoid acid can also be used ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Successful Treatment of Kaposi’s Sarcoma With Anlotinib in an HIV-Negative Patient After the Treatment of Drug Reaction With Eosinophilia and Systemic Symptoms Accessory Tragus

et al. 2022

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Kaposi’s Sarcoma (KS) is a neoplasm derived from endothelial cells and is associated with human herpesvirus-8 (HHV-8) infection. It is mostly seen in patients suffering from AIDS and/or chronic immunosuppression. Currently, systemic chemotherapy is the primary treatment option for the advanced KS. However, there is no consensus on the treatment of KS. In this case, an 84-year-old man with a history of psoriasis developed multiple painful dark purple nodules on the trunk and extremities during the treatment of drug reaction with eosinophilia and systemic symptoms (DRESS). KS was confirmed by the skin biopsy, and the immunohistochemical staining demonstrated the positivity for HHV-8 while the anti-HIV test was negative. The patient then received anlotinib treatment, a tyrosine kinase inhibitor, for 5 months, and his skin lesions subsided. This case indicates that anlotinib may be a potential treatment option for KS.

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Electrochemotherapy in Kaposi sarcoma: A systematic review

Cited by 10 publications

References 19 publications

Cutaneous and subcutaneous Kaposi's sarcoma lesions treated with electrochemotherapy

Cutaneous and subcutaneous Kaposi's sarcoma lesions treated with electrochemotherapy

Electrochemotherapy of skin metastases from malignant melanoma: a PRISMA-compliant systematic review

Case Report: Successful Treatment of Kaposi’s Sarcoma With Anlotinib in an HIV-Negative Patient After the Treatment of Drug Reaction With Eosinophilia and Systemic Symptoms Accessory Tragus

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