Minimally invasive treatment by electroporation: Remaining challenges

Abstract

The clinical use of electroporation in combination with chemotherapeutic drugs, electrochemotherapy (ECT), gained acceptance, and its effectiveness has been widely demonstrated in several cutaneous pathologies such as metastatic melanoma, basal cell carcinoma, squamous cell carcinoma, Kaposi sarcoma, and cutaneous recurrences from breast cancer. Overall, the body of clinical evidence available provided the support needed to expand clinical investigation and application of the therapy to pathologies and tumor nodules not confined to the skin or immediate subcutaneous tissues. The standard operating procedure developed within the European Standard Operating Procedures on Electrochemotherapy (ESOPE) project has been applied to the non-superficial tumors in the ESOPE II: the treatment of advanced pancreatic adenocarcinoma, metastases to the bone, large soft tissue tumors, and liver metastases has been investigated. The development of new electrodes and an implementation of pretreatment planning allowed the translation of the acquired experience in the deep-seated tumor. The results obtained confirmed that ECT is safe, well tolerated, and able to improve quality of life (QoL) of the patients, and its use is encouraged when standard therapy including surgery and radiotherapy are not possible or ineffective. Furthermore, electrochemotherapy is specifically indicated in oligometastatic patients for effective local tumor control.