Electrochemotherapy

Maker illustration

The electrochemotherapy (ECT) is a currently in clinical trials tested method of palliative therapy of superficially situated tumors which chemotherapeutic agents by electroporation to carry into the cell interior. The local application of short and intense electrical impulses opens the pores of the cell membrane and temporarily allows molecules to pass through, which otherwise could not penetrate a cell membrane. The first uses are in bleomycin and cisplatin for skin cancer, superficial sarcomas, and head and neck tumors. The response rates of these drugs in the preliminary studies were significantly higher than without electroporation.

In addition to the simple devices that are only sold in the wellness sector, some providers also offer devices for medical electroporation. The devices offered work z. B. with a voltage of 1,000 volts and eight pulses of 100 microseconds.

Clinical relevance

In a number of clinical studies, a significant response rate was found with the use of electrochemotherapy with the use of certain chemotherapeutic agents for different cutaneous or subcutaneous metastases or tumors, with advantages over other purely chemotherapeutic methods in terms of tumor size reduction. The AWMF's S3 guideline on melanoma published in February 2013 gives a weak recommendation ("can be used") for ECT in patients with satellite and in-transit metastases. The guideline on breast cancer published by the AGO (Gynecological Oncology Working Group), also published in 2013, lists electrochemotherapy as a treatment option for loco-regional relapse in non-curative cases.

Sources and individual references

1. ↑ Eric VanSonnenberg, William McMullen, Luigi Solbiati: Tumor Ablation: Principles and Practice . Springer, July 13, 2005, ISBN 978-0-387-95539-1 , pp. 295–6 (accessed March 10, 2013).
2. ↑ LM Mir, S. Orlowski, J. Belehradek, C. Paoletti: Electrochemotherapy potentiation of antitumour effect of bleomycin by local electric pulses. In: European Journal of Cancer (Oxford, England: 1990). Volume 27, Number 1, 1991, pp. 68-72, ISSN  0959-8049 . PMID 1707289 .
3. ↑ B. Mali, T. Jarm, M. Snoj, G. Sersa, D. Miklavcic: Antitumor effectiveness of electrochemotherapy: a systematic review and meta-analysis. In: European Journal of Surgical Oncology . Volume 39, Number 1, January 2013, pp. 4-16, ISSN  1532-2157 . doi: 10.1016 / j.ejso.2012.08.016 . PMID 22980492 . (Review).
4. ↑ Stephen T. Kee: Clinical Aspects of Electroporation . Springer, January 1, 2011, ISBN 978-1-4419-8363-3 , pp. 55–63 (accessed March 10, 2013).
5. ↑ S3 guideline “Diagnosis, Therapy and Follow-up Care of Melanoma.” ( Memento of the original from March 19, 2016 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. (PDF; 3.1 MB), p. 123 
6. ↑ Diagnosis and therapy of patients with primary and metastatic breast cancer, called on July 16, 2014, p. 347

literature

• Richard Gilbert: Electrochemotherapy, Electrogenetherapy, and Transdermal Drug Delivery: Electrically Mediated Delivery of Molecules to Cells . Springer, February 18, 2000, ISBN 978-0-89603-606-2 (accessed March 10, 2013).
• Alexander Kreuter et al .: Electrochemotherapy for advanced skin tumors and skin metastases - a retrospective multicenter evaluation . John Wiley & Sons Ltd. doi: 10.1111 / ddg.12583 ., October 27, 2014 (accessed May 19, 2015).
• Video of an application: G. Sersa, D. Miklavcic: Electrochemotherapy of tumors. In: Journal of visualized experiments: JoVE. Number 22, 2008, p., ISSN  1940-087X . doi: 10.3791 / 1038 . PMID 19229171 . PMC 2762922 (free full text).
• Probst U, Fuhrmann I, Beyer L, Wiggermann P. Electrochemotherapy as a New Modality in Interventional Oncology: A Review . Technol Cancer Res Treat 2018, doi: 10.1177 / 1533033818785329 , PMC 6048674 (free full text). PMID 29986632