Veneto Region Oncology Research Institute IOV IRCCS

Padova, Italy

Veneto Region Oncology Research Institute IOV IRCCS

Padova, Italy
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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.


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).


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.


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.


Tosi A.L.,Veneto Institute of Oncology IOV IRCCS | Campana L.G.,Veneto Region Oncology Research Institute IOV IRCCS | Dughiero F.,University of Padua | Forzan M.,University of Padua | And 3 more authors.
IFMBE Proceedings | Year: 2016

Tissue electrical conductivity is correlated to tissue characteristics. In this work some tumor mass excised from patients has been evaluated in terms of histological characteristics (cell size and density) and electrical resistance. © Springer Science+Business Media Singapore 2016.


Valpione S.,Veneto Region Oncology Research Institute IOV IRCCS | Moser J.C.,Mayo Medical School | Parrozzani R.,GB Bietti Foundation IRCCS | Bazzi M.,University of Padua | And 8 more authors.
PLoS ONE | Year: 2015

Background: Approximately 50% of patients with uveal melanoma (UM) will develop metastatic disease, usually involving the liver. The outcome of metastatic UM (mUM) is generally poor and no standard therapy has been established. Additionally, clinicians lack a validated prognostic tool to evaluate these patients. The aim of this work was to develop a reliable prognostic nomogram for clinicians. Patients and Methods: Two cohorts of mUM patients, from Veneto Oncology Institute (IOV) (N=152) and Mayo Clinic (MC) (N=102), were analyzed to develop and externally validate, a prognostic nomogram. Results: The median survival of mUM was 17.2 months in the IOV cohort and 19.7 in the MC cohort. Percentage of liver involvement (HR 1.6), elevated levels of serum LDH (HR 1.6), and a WHO performance status=1 (HR 1.5) or 2-3 (HR 4.6) were associated with worse prognosis. Longer disease-free interval from diagnosis of UM to that of mUM conferred a survival advantage (HR 0.9). The nomogram had a concordance probability of 0.75 (SE .006) in the development dataset (IOV), and 0.80 (SE .009) in the external validation (MC). Nomogram predictions were well calibrated. Conclusions: The nomogram, which includes percentage of liver involvement, LDH levels, WHO performance status and disease free-interval accurately predicts the prognosis of mUM and could be useful for decision-making and risk stratification for clinical trials. © 2015 Valpione et al.


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.


PubMed | University of Padua, GB Bietti Foundation IRCCS, Veneto Region Oncology Research Institute IOV IRCCS Padua, Mayo Medical School and 2 more.
Type: Journal Article | Journal: PloS one | Year: 2015

Approximately 50% of patients with uveal melanoma (UM) will develop metastatic disease, usually involving the liver. The outcome of metastatic UM (mUM) is generally poor and no standard therapy has been established. Additionally, clinicians lack a validated prognostic tool to evaluate these patients. The aim of this work was to develop a reliable prognostic nomogram for clinicians.Two cohorts of mUM patients, from Veneto Oncology Institute (IOV) (N=152) and Mayo Clinic (MC) (N=102), were analyzed to develop and externally validate, a prognostic nomogram.The median survival of mUM was 17.2 months in the IOV cohort and 19.7 in the MC cohort. Percentage of liver involvement (HR 1.6), elevated levels of serum LDH (HR 1.6), and a WHO performance status=1 (HR 1.5) or 2-3 (HR 4.6) were associated with worse prognosis. Longer disease-free interval from diagnosis of UM to that of mUM conferred a survival advantage (HR 0.9). The nomogram had a concordance probability of 0.75 (SE .006) in the development dataset (IOV), and 0.80 (SE .009) in the external validation (MC). Nomogram predictions were well calibrated.The nomogram, which includes percentage of liver involvement, LDH levels, WHO performance status and disease free-interval accurately predicts the prognosis of mUM and could be useful for decision-making and risk stratification for clinical trials.


Valpione S.,Veneto Region Oncology Research Institute IOV IRCCS | Campana L.G.,Veneto Region Oncology Research Institute IOV IRCCS | Pigozzo J.,Veneto Region Oncology Research Institute IOV IRCCS | Chiarion-Sileni V.,Veneto Region Oncology Research Institute IOV IRCCS
Radiology and Oncology | Year: 2015

Background. Small molecules that inhibit V600 mutated BRAF protein, such as vemurafenib and dabrafenib, are effective in treatment of metastatic melanoma. Case report. We here describe the clinical course of a V600E BRAF mutated metastatic melanoma patient with systemic disease, who developed tumor progression on superficial soft-tissue metastases during treatment with dabrafenib. Bleomycin electrochemotherapy during dabrafenib treatment was administered to control the soft-tissue progressing metastases and ensured sustained local control without significant toxicity. Conclusions. The new combined approach maintained the patient quality of life and allowed for the prosecution of the target therapy, which proved to be still effective on systemic disease, up to 17 months.


PubMed | Veneto Region Oncology Research Institute IOV IRCCS
Type: Journal Article | Journal: Radiology and oncology | Year: 2015

Small molecules that inhibit V600 mutated BRAF protein, such as vemurafenib and dabrafenib, are effective in treatment of metastatic melanoma.We here describe the clinical course of a V600E BRAF mutated metastatic melanoma patient with systemic disease, who developed tumor progression on superficial soft-tissue metastases during treatment with dabrafenib. Bleomycin electrochemotherapy during dabrafenib treatment was administered to control the soft-tissue progressing metastases and ensured sustained local control without significant toxicity.The new combined approach maintained the patient quality of life and allowed for the prosecution of the target therapy, which proved to be still effective on systemic disease, up to 17 months.

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