Electrochemotherapy of Melanoma Cutaneous Metastases in Organ Transplant Recipients: A Systematic Review of Preclinical and Clinical Studies

Abstract

Cutaneous melanoma is a highly aggressive form of skin cancer. The development of immune checkpoint inhibitors (ICIs) has revolutionized the management of advanced melanoma, led to durable responses, and improved overall survival. However, the success of ICIs in melanoma treatment is influenced by the tumor microenvironment (TME) which plays a critical role in regulating the immune response to the tumor. Understanding the mechanisms underlying this interaction is crucial to optimizing the efficiency of ICIs. Electrochemotherapy (ECT) has been shown to enhance the efficacy of ICIs in melanoma treatment by inducing tumor cell death and facilitating the release of tumor antigens which can subsequently be recognized and targeted by the immune system. Moreover, ECT has been reported to modulate the TME, leading to increased infiltration of immune cells and a more favorable immunological profile. In this review, we summarize the available knowledge of changes in TME after ECT of melanoma cutaneous metastasis and highlight the differences in tumor-infiltrating immune cells between immunocompetent and immunosuppressed organisms. In addition, we showed that ECT can be an effective and safe procedure for organ transplant recipients. Furthermore, repeated ECT may enhance immune activation and probably induce a bystander effect by trained immunity.

Treatment of vulvar cancer recurrence with electrochemotherapy: a case-control study

“…Secondly, the patients included in the ECT group and the surgical group were patients with similar clinical characteristics and were homogeneous in terms of the same histological type, previous treatments, and anatomical sites. Thirdly, our center is an important referral center for ECT treatment and has important experience [9,12,14,38,39].…”

“…Electrochemotherapy (ECT) is a combined modality treatment based on electroporation and concurrent chemotherapy, usually bleomycin, administered intravenously [7]. It is already used for the treatment of superficial tumors such as melanoma, sarcoma, squamous cell carcinoma, basal cell carcinoma, and also for the treatment of deep-seated tumors, such as primary hepatocellular carcinoma and colorectal liver metastases [8][9][10][11][12]. For deep-seated tumors, not only open surgery approach, but also percutaneous and laparoscopic methods have been developed [13,14].…”