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Testori A.,Italian National Cancer Institute | Rossi C.R.,Veneto Region Oncology Research Institute IOV IRCCS | Tosti G.,Italian National Cancer Institute
Current Opinion in Oncology | Year: 2012

PURPOSE OF REVIEW: In the present study, the role of electrochemotherapy (ECT) in the advanced melanoma setting, either as alternative treatment modality to conventional therapies or as palliative care, is reviewed and the perspective to combine ECT with biological response modifiers and immunotherapeutic compounds is discussed. RECENT FINDINGS: ECT refers to the combination of electroporation and administration of anticancer drugs for local treatment of solid neoplasms. Electroporation uses short and intense electric pulses to induce a transient permeabilization of the cell membrane by creation of pores, thus allowing molecules, such as chemotherapeutic agents, to freely diffuse into the cytosol. ECT has shown to be effective and clinically well tolerated in the local control of primary and metastatic solid tumors of diverse histotypes in preclinical and clinical studies, thus, emerging as useful local treatment modality for disseminated superficial melanoma. So far, only a few data on the role of immunological response in ECT-treated patients have been reported. SUMMARY: Treatment regimens combining ECT to biological response modifiers (interleukin-2, interferon) and immunotherapeutic compounds should be further explored in animal and human cancer models; immunotherapy combined to ECT could broaden the therapeutic indications of ECT, by rendering it effective also on distant unreachable or untreated lesions. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source


Mali B.,University of Ljubljana | Miklavcic D.,University of Ljubljana | Campana L.G.,Veneto Region Oncology Research Institute IOV IRCCS | Cemazar M.,Institute of Oncology Ljubljana | And 3 more authors.
Radiology and Oncology | Year: 2013

Background. Electrochemotherapy (ECT) is an effective and safe method for local treatment of tumors. However, relatively large variability in effectiveness of ECT has been observed, which likely results from different treatment conditions and tumor characteristics. The aim of this study was to investigate the relationship between tumor size and effectiveness of a single-session ECT. Materials and methods. A systematic search of various bibliographic databases was performed and nine studies eligible for this study were extracted. Different statistical methods including meta-analysis were applied to analyze the data. Results. The results of analysis based on data from 1466 tumors of any histotype show significantly lower effectiveness of ECT on tumors with maximal diameter equal to or larger than 3 cm (complete response (CR) of 33.3%, objective response (OR) of 68.2%) in comparison to smaller tumors (CR% of 59.5%, OR% of 85.7%). The results of meta-analysis indicated that ECT performed on tumors smaller than 3 cm statistically significantly increases the probability of CR by 31.0% and OR by 24.9% on average in comparison to larger tumors. The analysis of raw data about the size and response of tumors showed statistically significant decrease in effectiveness of ECT progressively with increasing tumor diameter. The biggest drop in CR% was detected at tumor diameters as small as 2 cm. Conclusions. The standard operating procedures for ECT should be reexamined and refined for the treatment of large tumors. We propose that future clinical trials should include accurate ECT treatment planning and/or multiple ECT cycles, besides a prolonged observation for tumor response evaluation. Copyright © 2011-2013 by Walter de Gruyter GmbH. Source


Campana L.G.,Veneto Region Oncology Research Institute IOV IRCCS | Di Barba P.,University of Pavia | Dughiero F.,University of Padua | Rossi C.R.,Veneto Region Oncology Research Institute IOV IRCCS | Sieni E.,University of Padua
IEEE Transactions on Magnetics | Year: 2013

A multiobjective optimization method is used to design a treatment planning based on electrochemotherapy (ECT). A penalty function technique is coupled to NSGA algorithm in order to identify the constrained Pareto front, so preventing unfeasible solutions. © 1965-2012 IEEE. Source


Miklavcic D.,University of Ljubljana | Sersa G.,Institute of Oncology Ljubljana | Brecelj E.,Institute of Oncology Ljubljana | Gehl J.,Copenhagen University | And 6 more authors.
Medical and Biological Engineering and Computing | Year: 2012

Electrochemotherapy, a combination of high voltage electric pulses and of an anticancer drug, has been demonstrated to be highly effective in treatment of cutaneous and subcutaneous tumors. Unique properties of electrochemotherapy (e.g., high specificity for targeting cancer cells, high degree of localization of treatment effect, capacity for preserving the innate immune response and the structure of the extracellular matrix) are facilitating its wide spread in the clinics. Due to high effectiveness of electrochemotherapy in treatment of cutaneous and subcutaneous tumors regardless of histological origin, there are now attempts to extend its use to treatment of internal tumors. To advance the applicability of electrochemotherapy to treatment of internal solid tumors, new technological developments are needed that will enable treatment of these tumors in daily clinical practice. New electrodes through which electric pulses are delivered to target tissue need to be designed with the aim to access target tissue anywhere in the body. To increase the probability of complete tumor eradication, the electrodes have to be accurately positioned, first to provide an adequate extent of electroporation of all tumor cells and second not to damage critical healthy tissue or organs in its vicinity. This can be achieved by image guided insertion of electrodes that will enable accurate positioning of the electrodes in combination with patient-specific numerical treatment planning or using a predefined geometry of electrodes. In order to be able to use electrochemotherapy safely for treatment of internal tumors located in relative proximity of the heart (e.g., in case of liver metastases), the treatment must be performed without interfering with the heart's electrical activity. We describe recent technological advances, which allow treatment of liver and bone metastases, soft tissue sarcomas, brain tumors, and colorectal and esophageal tumors. The first clinical experiences in these novel application areas of electrochemotherapy are also described. © 2012 The Author(s). Source


Campana L.G.,Veneto Region Oncology Research Institute IOV IRCCS | Dughiero F.,University of Padua | Forzan M.,University of Padua | Rastrelli M.,Veneto Region Oncology Research Institute IOV IRCCS | And 3 more authors.
IFMBE Proceedings | Year: 2015

Electrical properties of human soft tissue lipomatous tumors during electrochemotherapy have been evaluated and the resistance values have been correlated to the histopathological features. © Springer International Publishing Switzerland 2015. Source

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