Electrochemotherapy in the Treatment of Kaposi Sarcoma Cutaneous Lesions: A Two-Center Prospective Phase II Trial

Curatolo, P.; Quaglino, Pietro; Marenco, Federica; Mancini, Monica; Nardò, Tiziana; Mortera, C; Rotunno, Roberta; Calvieri, Stefano; Bernengo, Maria Grazia

doi:10.1245/s10434-011-1860-7

Cited by 87 publications

(91 citation statements)

References 32 publications

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“…ECT treatment has been confirmed to be an effective and well tolerated treatment modality for the local control of unresectable and/or refractory superficially disseminated melanoma in patients who are not suitable for standard oncological therapies. The absence of systemic side effects and the low impact on the immune system also make this treatment suitable for elderly people, even with repeated courses [26].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Bleomycin-based electrochemotherapy in patients with repeated loco-regional recurrences of vulvar cancer

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Outcomes of Bleomycin-based electrochemotherapy in patients with repeated loco-regional recurrences of vulvar cancer

et al. 2016

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“…on May 10, 2018. by guest www.bloodjournal.org From addition, we also consider surgical excision, and, to a lesser extent, electro-chemotherapy, 95,96 for limited cutaneous PT-KS lesions, refractory to the changes of immunosuppressive regimen. Radiotherapy has largely been abandoned at our center because of persistently associated local side effects (eg, edema, ulcerative lesions; III).…”

Section: Hhv8/kshv-related Diseases 4155mentioning

confidence: 99%

How I treat HHV8/KSHV-related diseases in posttransplant patients

Riva¹,

Luppi²,

Barozzi³

et al. 2012

Blood

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Posttransplantation human herpesvirus-8 (HHV8)/Kaposi sarcoma herpesvirus (KSHV) primary infection and/or reactivations are associated with uncommon and sometimes fatal, neoplastic, and nonneoplastic diseases. HHV8-related clinical manifestations notably range from Kaposi sarcoma (KS) to either primary effusion lymphoma or multicentric Castleman disease B-cell malignancies, and from polyclonal HHV8-positive plasmacytic lymphoproliferative disorders to bone marrow failure and peripheral cytopenias, associated or not with hemophagocytic syndromes, and to acute hepatitis syndromes. We reviewed the patient series reported in the literature and summarized clinical management aspects, in terms of diagnosis, follow-up, and treatment. We described typical clinical presentations and histopathologic diagnostic features of these diseases, and we discussed the role of HHV8-specific serologic, molecular, and immunologic assays, particularly focusing on recent data from HHV8-specific T-cell monitoring in posttransplantation KS patients. We finally discussed actual therapeutic options, namely, the reduction or discontinuation of immunosuppressive therapy or the switch from calcineurin inhibitors to mTOR inhibitors, as alternatives to antineoplastic chemotherapy, along with the use of antiherpesvirus agents as prophylactic or therapeutic measures, and treatment with rituximab in posttransplantation multicentric Castleman disease patients and non-neoplastic HHV8-associated syndromes. IntroductionHerpesvirus-associated hematologic diseases often represent primary clinical challenges during the multidisciplinary follow-up of posttransplant patients, either with hematopoietic stem cell transplant (HSCT) or with solid organ transplant (SOT). In immunosuppressed organ recipients, latent human ␥-herpesvirus, namely, EBV and human herpesvirus-8 (HHV8)/Kaposi sarcoma herpesvirus (KSHV) are typically responsible for several virus-driven neoplastic proliferations, as well as they may sometimes cause uncommon, but equally life-threatening, non-neoplastic infectious complications. During the past decade, large amounts of experimental evidence have come out on these topics, and some of them have yet begun to influence the clinical behavior, in terms of diagnosis and treatment. Chiefly, EBV-related complications have been extensively studied and discussed, so that now physicians can rely on accurate and updated clinical recommendations, in particular dealing with early diagnosis, monitoring and treatment of EBV ϩ posttransplantation lymphoproliferative diseases (PTLDs). 1 With regards to HHV8, practical management of the virus-associated neoplastic lymphoproliferations has deeply been revised in HIVpositive subjects, 2,3 whereas in SOT and HSCT settings, the diagnostic and therapeutic issues about the various HHV8-driven manifestations (either neoplastic or non-neoplastic) are only occasionally reported in the literature, but most of these diseases revealed to be rapidly lethal if not timely recognized and adequately treated. Indeed, posttra...

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“…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%

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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Electrochemotherapy in the Treatment of Kaposi Sarcoma Cutaneous Lesions: A Two-Center Prospective Phase II Trial

Cited by 87 publications

References 32 publications

Outcomes of Bleomycin-based electrochemotherapy in patients with repeated loco-regional recurrences of vulvar cancer

Outcomes of Bleomycin-based electrochemotherapy in patients with repeated loco-regional recurrences of vulvar cancer

How I treat HHV8/KSHV-related diseases in posttransplant patients

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

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