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Electrochemotherapy of cancer – therapeutic perspectives<br />
Gregor Ser{a for the ESOPE group<br />
Institute of Oncology, Zalo{ka 2, SI-1000 Ljubljana, Slovenia<br />
Electrochemotherapy consists of chemotherapy followed by local application of<br />
electric pulses to the tumour to increase drug delivery into cells. Drug uptake can<br />
be increased by electroporation for only those drugs whose transport through the<br />
plasma membrane is impeded. Among many drugs that have been tested so far,<br />
only bleomycin and cisplatin found their way from preclinical testing to clinical<br />
trials. In vitro studies demonstrated several fold increase of their cytotoxicity after<br />
electroporation of cells. In vivo, electroporation of tumours after local or systemic<br />
administration of either of the drugs, i.e. electrochemotherapy, proved to be an<br />
effective antitumour treatment<br />
Physico-chemical basis of this therapy allows prediction that electrochemotherapy<br />
has good antitumour effect on all tumour types, which was demonstrated in several<br />
clinical studies. The ESOPE clinical trial has demonstrated that an objective response<br />
rate of 85% (73.7% complete response rate) was achieved on the electrochemotherapy<br />
treated tumour nodules, regardless of tumour histology, and drug used or route of<br />
its administration.<br />
The clinical experience gained so far in the ESOPE project provided evidence that<br />
electrochemotherapy is successful treatment in various clinical indications:<br />
• Easy and effective treatment of single or multiple tumour nodules of any<br />
histology in the cutaneous and subcutaneous tissue.<br />
• Treatment that increases quality of life in patients with progressive disease.<br />
38l23<br />
• Treatment of choice for tumours refractory to conventional treatments.<br />
• Neoadjuvant treatment in form of cytoreductive therapy before conventional<br />
treatment.<br />
• Organ sparing and function saving treatment.<br />
• Treatment of hemorrhagic or painful nodules, since it reduces bleeding and in<br />
some cases pain level.<br />
All these indications provide electrochemotherapy broad spectrum of use, predominantly<br />
because electrochemotherapy is effective local therapy and additionally<br />
quick and easy to perform.<br />
• Ser{a G, Cema`ar M, Rudolf Z. Electrochemotherapy: advantages and drawbacks<br />
in treatment of cancer patients. Cancer Therapy 2003; 1: 133-42.<br />
• Gothelf A, Mir LM, Gehl J. Electrochemotherapy: results of cancer treatment<br />
using enhanced delivery of bleomycin by electroporation. Cancer Treat<br />
Rev 2003; 29: 371-87.<br />
The ESOPE (QLK3-20<strong>02</strong>-<strong>02</strong>003) study was supported by EU commission project, and<br />
Research Agency of Slovenia.
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