Abstract
Electrochemotherapy (ECT) is an effective bioelectrochemical procedure that uses controlled electrical pulses to facilitate the increase of intracellular concentration of certain substances (electropermeabilization/ reversible electroporation). ECT using antitumor drugs such as bleomycin and cisplatin is a minimally invasive targeted therapy that can be used as an alternative for oncologic patients not eligible for surgery or other standard therapies. Even though ECT is mainly applied as palliative care for metastases, it may also be used for primary tumors that are unresectable due to size and location. Skin neoplasms are the main clinical indication of ECT, the procedure reporting good curative results and high efficiency across all tumor types, including melanoma. In daily practice, there are many cases in which the patient’s quality of life can be significantly improved by a safe procedure such as ECT. Its popularity must be increased because it has a safe profile and minor local adverse reactions. The method can be used by dermatologists, oncologists, and surgeons. The aim of this paper is to review recent literature concerning electrochemotherapy and other clinical applications of electroporation for the targeted therapy of metastatic melanoma.
Highlights
Licensee MDPI, Basel, Switzerland.The main cause of death in oncology is represented by cancer progression through metastasis, with the dissemination to secondary organs [1,2], and significant efforts are being made to the development of novel therapeutic strategies to combat metastatic cancer [3].Electrochemotherapy (ECT) is an effective bioelectrochemical procedure that uses controlled electrical pulses to facilitate the increase of intracellularAttribution (CC BY) license.concentration of certain substances
The aim of this paper is to review recent literature concerning electrochemotherapy use in metastatic melanoma
The ECT procedure inclusively for skin melanoma metastases is detailed in the published studies of ESOPE (European Standard Operating Procedures of Electrochemotherapy) and SOP (Standard Operating Procedures), the treatment being performed according to these standards [20,26,43]
Summary
Reversible electroporation facilitates the chemical substance to penetrate cellular membranes, which is useful in the case of chemotherapeutic agents with low permeability. After these molecules achieve optimal intracellular concentrations, they exert their effect on the targeted tumor cells. Bleomycin (BLM) and cisplatin (CDDP) have a hydrophilic structure, with poor ability to cross cell membranes [15] These two drugs have shown the best results when administered intravenously or intratumorally at appropriate time moments prior to applying local electric pulses to be present in an efficient concentration outside the cell when its membrane is permeabilized by the electric field [16,17]. The aim of this paper is to review recent literature concerning electrochemotherapy use in metastatic melanoma
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