Introduction to Electrochemotherapy (ECT)
Cancer is one of the most difficult current health challenges, being responsible for millions of deaths yearly. Systemic chemotherapy is the most common therapeutic approach, and the prevailing orientation calls for the administration of the maximum tolerated dose; however, considerable limitations exist including toxicities to healthy tissues and low achievable drug concentrations at tumor sites. Tumor microenvironment represents a key obstacle for the effectiveness of anticancer drugs.
Spugnini EP, Baldi A. Electrochemotherapy in Veterinary Oncology: State-of-the-Art and Perspectives. Vet Clin North Am Small Anim Pract. 2019 Sep;49(5):967-979. https://pubmed.ncbi.nlm.nih.gov/31176458/
Electrochemotherapy (ECT) is a loco-regional therapy characterized by the application of permeabilizing electric pulses on tumors after the systemic or intralesional administration of a chemotherapy drug. ECT is presently used as first-line therapy in an adjuvant fashion in veterinary oncology, since it has been proved to improve the efficacy of chemotherapeutic agents and their uptake by the neoplastic cells.
Electrochemotherapy involves the systemic or local delivery of lipophobic drugs such as bleomycin and cisplatin, with the application of permeabilizing electric pulses having appropriate amplitude and waveforms. This greatly enhances the uptake of these drugs by an estimated factor of 700-fold for bleomycin and 4 to 8 times for cisplatin.
Advantages and Applications
In comparison to other standard treatments, such as surgery or radiotherapy, Electrochemotherapy ECT has the additional advantage of rapid action on multiple lesions and with repeated sessions in the absence of significant side effects and with no functional impairment.
In humans, the use of Electrochemotherapy ECT was initially limited to the palliation of cutaneous metastases of melanoma, and several phase II trials are ongoing for different tumor types with promising results. In particular, Electrochemotherapy ECT is emerging as a valid therapeutic and palliative treatment for cutaneous and subcutaneous malignancies, including SCC.
Biopulse Biotech research group, with OnkoDisruptor® electroporators, has proposed a novel protocol for Electrochemotherapy ECT involving the adoption of bursts of rectangular and biphasic pulses with a selectable period of repetition. This protocol has been shown to decrease the morbidity of the treated animals and to improve the clinical outcome. It has been already successfully used in humans for the treatment of large viral warts.