Updated standard operating procedures for electrochemotherapy of cutaneous tumours and skin metastases

Julie GehlCenter for Experimental Drug and Gene Electrotransfer (C*EDGE), Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark; ;Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; ;Department of Oncology Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark; Correspondence[email protected]

http://orcid.org/0000-0003-3829-0210

Gregor SersaDepartment of Experimental Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia;

Louise Wichmann MatthiessenDepartment of Oncology Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark;

Tobian MuirSouth Tees NHS Foundation Trust, James Cook University Hospital, Middlesbrough, UK;

Declan SodenCork Cancer Research Centre, Western Gateway Building University College Cork, Cork, Ireland;

Antonio OcchiniDepartment of Otolaryngology Head and Neck Surgery, University of Pavia – IRCCS Policlinico San Matteo Foundation, Pavia, Italy;

Pietro QuaglinoDepartment of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy;

Pietro CuratoloDepartment of Dermatology and Plastic Surgery, La Sapienza University, Roma, Italy;

Luca G. CampanaDepartment of Surgery Oncology and Gastroenterology (DISCOG), University of Padova, Padova, Italy; ;Surgical Oncology Unit, Veneto Institute of Oncology IRCCS, Padova, Italy;

Christian KunteDepartment of Dermatologic Surgery and Dermatology, Artemed Fachklinik München, Munich, Germany; ;Department of Dermatology and Allergology, Ludwig-Maximillian University, Munich, Germany;

http://orcid.org/0000-0002-3220-9816

A. James P. CloverCork Cancer Research Centre, Western Gateway Building University College Cork, Cork, Ireland; ;Department of Plastic Surgery, Cork University Hospital, Cork, Ireland;

Giulia BertinoCork Cancer Research Centre, Western Gateway Building University College Cork, Cork, Ireland;

Victor FarrichaMelanoma and Sarcoma Unit Department of Surgery, Portuguese Institute of Oncology, Rua Professor Lima Basto, Faculty of Medicine of Lisbon, Lisbon, Portugal;

Joy OdiliDepartment of Plastic Surgery, St. George’s University Hospitals NHS Foundation Trust, London, UK;

Karin DahlstromDepartment of Plastic Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark;

Marco BenazzoDepartment of Otolaryngology Head and Neck Surgery, University of Pavia – IRCCS Policlinico San Matteo Foundation, Pavia, Italy;

Lluis M. MirVectorology and Anticancer Therapies, UMR 8203, CNRS, Univ. Paris-Sud, Gustave Roussy, Université Paris-Saclay, Villejuif, France

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Abstract

Electrochemotherapy is now in routine clinical use to treat cutaneous metastases of any histology, and is listed in national and international guidelines for cutaneous metastases and primary skin cancer. Electrochemotherapy is used by dermatologists, surgeons, and oncologists, and for different degrees and manifestations of metastases to skin and primary skin tumours not amenable to surgery. This treatment utilises electric pulses to permeabilize cell membranes in tumours, thus allowing a dramatic increase of the cytotoxicity of anti-cancer agents. Response rates, often after only one treatment, are very high across all tumour types. The most frequent indications are cutaneous metastases from malignant melanoma and breast cancer. In 2006, standard operating procedures (SOPs) were written for this novel technology, greatly facilitating introduction and dissemination of the therapy. Since then considerable experience has been obtained treating a wider range of tumour histologies and increasing size of tumours which was not originally thought possible. A pan-European expert panel drawn from a range of disciplines from dermatology, general surgery, head and neck surgery, plastic surgery, and oncology met to form a consensus opinion to update the SOPs based on the experience obtained. This paper contains these updated recommendations for indications for electrochemotherapy, pre-treatment information and evaluation, treatment choices, as well as follow-up.

Acknowledgments

This paper has been written solely by the authors.

Disclosure statement

JG is an inventor of patents (however not regarding the topics covered in this paper) licensed to IGEA and has been invited to lecture at meetings on electrochemotherapy by IGEA. LMM is an inventor of CNRS patents related to cliniporator equipment and has paid consultancy for IGEA. CK received honoraria for lectures and was invited to meetings on electrochemotherapy by IGEA. Travel cost for one meeting regarding this work has been sponsored by IGEA.

Updated standard operating procedures for electrochemotherapy of cutaneous tumours and skin metastases

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Updated standard operating procedures for electrochemotherapy of cutaneous tumours and skin metastases

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