Aktuelle Dermatologie 2016; 42(12): 510-514
DOI: 10.1055/s-0042-120582
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Elektrochemotherapie – Möglichkeiten lokaler Tumorkontrolle

Electrochemotherapy – Possibilities of Local Tumor Management
F. Angeletti
Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt
,
M. Meissner
Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt
,
R. Kaufmann
Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt
,
E. Valesky
Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt
› Author Affiliations
Further Information

Publication History

Publication Date:
06 December 2016 (online)

Zusammenfassung

Die Elektrochemotherapie (ECT) ist ein Verfahren, bei dem mittels kurzer elektrischer Pulse lokal eine Erhöhung der Zellmembranpermeabilität erzielt wird. Gleichzeitig applizierte Chemotherapeutika können so in Tumorzellen gelangen und dort ihre Wirkung entfalten. Die Methode ist einfach anzuwenden und Nebenwirkungen sind gering. Sie eignet sich zur Therapie kutaner und subkutaner Tumoren, die durch chirurgische oder andere Verfahren nicht oder nur schwer zu behandeln sind. Bei fortgeschrittenen Tumorerkrankungen kann so eine gute lokale Tumorkontrolle erreicht und die Lebensqualität der Betroffenen, die häufig unter Blutungen und Geruchsentwicklung der Metastasen leiden, verbessert werden. Bei alten und/oder multimorbiden Patienten ist die Therapie einfach durchzuführen und weitgehend schonend. Neuere Erkenntnisse über immunologische Effekte bei der Kombination aus ECT und Immuntherapien eröffnen möglicherweise neue Therapieoptionen für Patienten mit metastasiertem Melanom.

Abstract

Electrochemotherapy (ECT) allows the delivery of chemotherapeutic agents into tumors through electroporation. The method is easy to apply and side effects are mild. When surgical resection or other procedures are contraindicated or impossible to perform, ECT offers an alternate treatment option for cutaneous and subcutaneous metastases. By this means in patients with advanced disease local tumor control can be achieved. Also quality of life, which is often impaired due to bleeding and fetor, can be improved. Even elderly and patients with many concomitant illnesses can profit from ECT. Furthermore, insights on immunologic effects when ECT and immunotherapies are combined, offer new treatment options for patients with malignant melanoma in the future.

 
  • Literatur

  • 1 Lookingbill DP, Spangler N, Helm KF. Cutaneous metastases in patients with metastatic carcinoma: a retrospective study of 4020 patients. J Am Acad Dermatol 1993; 2: 228-236
  • 2 Guida M, Campana LG, Curatolo P et al. Local treatment with electrochemotherapy of superficial angiosarcomas: Efficacy and safety results from a multi-institutional retrospective study. J Surg Oncol 2016; 114: 246-253
  • 3 Di Monta G, Caracò C, Benedetto L et al. Electrochemotherapy as ‘new standard of care’ treatment for cutaneous Kaposi’s sarcoma. Eur J Surg Oncol 2014; 40: 61-66
  • 4 Neumann E, Schaefer-Ridder M, Wang Y et al. Gene transfer into mouse lyoma cells by electroporation in high electric fields. EMBO J 1982; 1: 841-845
  • 5 Landström F, Ivarsson M, Von Sydow AK et al. Electrochemotherapy – Evidence for Cell-type Selectivity In Vitro. Anticancer Res 2015; 35: 5813-5820
  • 6 Miklavčič D, Mali B, Kos B et al. Electrochemotherapy: from the drawing board into medical practice. Biomed Eng Online 2014; 13: 29
  • 7 Mir LM, Gehl J, Sersa G et al. Standard operating procedures of the electrochemotherapy: Instructions for the use of bleomycin or cisplatin administered either systemically or locally and electric pulses delivered by the CliniporatorTM by means of invasive or non-invasive electrodes. Eur J Cancer Suppl. 2006; 4: 14-25
  • 8 Maglietti F, Tellado M, Olaiz N et al. Combined local and systemic bleomycin administration in electrochemotherapy to reduce the number of treatment sessions. Radiol Oncol 2016; 50: 58-63
  • 9 Matthiessen LW, Johannesen HH, Hendel HW et al. Electrochemotherapy for large cutaneous recurrence of breast cancer: a phase II clinical trial. Acta Oncol 2012; 51: 713-721
  • 10 Kreuter A, van Eijk T, Lehmann P et al. Elektrochemotherapie bei fortgeschrittenen Hauttumoren und Hautmetastasen – eine retrospektive multizentrische Auswertung. JDDG 2015; 13: 308-316
  • 11 Deroose JP, Grünhagen DJ, Eggermont AM M et al. Repeated isolated limb perfusion in melanoma patients with recurrent in-transit metastases. Melanoma Res 2015; 25: 427-431
  • 12 Kroon BB R, Noorda EM, Vrouenraets BC et al. Isolated limb perfusion for melanoma. Surg Oncol Clin N Am 2008; 17: 785-794, viii – ix
  • 13 Mali B, Jarm T, Snoj M et al. Antitumor effectiveness of electrochemotherapy: a systematic review and meta-analysis. Eur J Surg Oncol 2013; 39: 4-16
  • 14 Campana LG, Mali B, Sersa G et al. Electrochemotherapy in non-melanoma head and neck cancers: a retrospective analysis of the treated cases. Br J Oral Maxillofac Surg 2014; 52: 957-964
  • 15 Dossett LA, Ben-Shabat I, Olofsson Bagge R et al. Clinical Response and Regional Toxicity Following Isolated Limb Infusion Compared with Isolated Limb Perfusion for In-Transit Melanoma. Ann Surg Oncol 2016; 23: 2330-2335
  • 16 Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen, D. K. e. V. (DKG) und Fachgesellschaften e. V. (AWMF) und Deutschen Krebshilfe(DKH). S3-Leitlinie zur Diagnostik, Therapie und Nachsorge des Melanoms. 2016
  • 17 National Institute for Health and Care Excellence (NICE). Electrochemotherapapy for primary basal cell carcinoma and primary squamous cell carcinoma Interventional procedure guidance. 2014
  • 18 Stratigos A, Garbe C, Lebbe C et al. Diagnosis and treatment of invasive squamous cell carcinoma of the skin: European consensus-based interdisciplinary guideline. Eur J Cancer 2015; 51: 1989-2007
  • 19 Lebbe C, Becker JC, Grob J-J et al. Diagnosis and treatment of Merkel Cell Carcinoma. European consensus-based interdisciplinary guideline. Eur J Cancer 2015; 51: 2396-2403
  • 20 Edhemovic I, Gadzijev EM, Brecelj E et al. Electrochemotherapy: a new technological approach in treatment of metastases in the liver. Technol Cancer Res Treat 2011; 10: 475-485
  • 21 Sersa G, Mikiavcic D, Cemazar M et al. Electrochemotherapy with CDDP on LPB sarcoma: comparison of the anti-tumor effectiveness in immunocompetent and immunodeficient mice. Bioelectrochemistry Bioenerg 1997; 43: 279-283
  • 22 Calvet CY, Mir LM. The promising alliance of anti-cancer electrochemotherapy with immunotherapy. Cancer Metastasis Rev 2016; 35: 165-177
  • 23 Sersa G, Teissie J, Cemazar M et al. Electrochemotherapy of tumors as in situ vaccination boosted by immunogene electrotransfer. Cancer Immunol Immunother 2015; 64: 1315-1327
  • 24 Daud AI, DeConti RC, Andrews S et al. Phase I trial of interleukin-12 plasmid electroporation in patients with metastatic melanoma. J Clin Oncol 2008; 26: 5896-5903
  • 25 Mozzillo N, Simeone E, Benedetto L et al. Assessing a novel immuno-oncology-based combination therapy: Ipilimumab plus electrochemotherapy. Oncoimmunology 2015; 4: e1008842
  • 26 Valpione S, Campana LG, Pigozzo J et al. Consolidation electrochemotherapy with bleomycin in metastatic melanoma during treatment with dabrafenib. Radiol Oncol 2015; 49: 71-74