Electrochemotherapy in the Treatment of Kaposi’s Sarcoma: A Single Centre Cohort Study and a Comparison with the Literature Data

Abstract

Background: Kaposi's sarcoma (KS) is a tumor of endothelial derivation, which primarily affects the skin and is mainly related to the type 8 Human Herpesvirus (HHV8). Its onset is favored by immunosuppression, although the most common form is the classic or spo-radic KS mainly developing in elderly men of Mediterranean and Eastern European origin. Dif-ferent therapeutic options are available, depending on the clinical variant, progression pattern, and comorbidities. The treatment of localized forms includes surgical excision, laser treatment, cryosurgery, radiotherapy, imiquimod 5%, and intra-lesion injection of cytotoxic drugs; on the other hand, the treatment of widespread disease encompasses radiotherapy and chemotherapy. Methods: In this scenario, Electrochemotherapy (ECT), has shown to be an effective alternative to traditional treatment for disseminated KS skin lesions. The rationale of ECT relies on the lo-cal application of short, high-voltage electric pulses, able to open transient pores in the cell membrane (reversible electroporation that increases the delivery of some poorly permeant cyto-toxic agents into the cytosol. Results: Herein, we performed a retrospective analysis on 9 KS patients treated with ECT at our center between June 2016 and January 2020. The rate of Complete Response (CR) was 77.8% after the first cycle of treatment and 88.9% after the second course, with an overall response (OR) of 100%. Conclusion: Sustained local control of treated lesions was present in 77.8% of patients 6 months after the treatment and all of them reported only mild local toxicity, together with an excellent functional and cosmetic outcome, in agreement with data obtained from the compari-son with the recent literature.