Comparison of two different doses of bleomycin in electrochemotherapy protocols for feline cutaneous squamous cell carcinoma nonsegregated from ultraviolet light exposure.

In the context of research on new electroporation protocols to be applied to feline tumors, an example of a study by our research group is the treatment of cutaneous Squamous Cell Carcinoma (cSCC), which is one of the most common skin tumors in cats due to chronic exposure to ultraviolet light. In these cases, local treatments such as electrochemotherapy (ECT) promote disease control or even complete remission.

Dos Anjos DS, Sierra OR, Spugnini EP, De Nardi AB, Fonseca-Alves CE. Comparison of two different doses of bleomycin in electrochemotherapy protocols for feline cutaneous squamous cell carcinoma nonsegregated from ultraviolet light exposure. Sci Rep. 2020 Oct 27;10(1):18362.  https://pubmed.ncbi.nlm.nih.gov/33110198/

Electroporation Enhances Bleomycin Efficacy in Cats with Periocular Carcinoma and Advanced Squamous Cell Carcinoma of the Head

Another application example is on advanced carcinoma of the head. This tumor represents a substantial health problem in cats for local control and overall survival. In this case there is a high capability of electrochemotherapy (ECT) to improve bleomycin efficacy in cats with periocular carcinoma (21 cats)  and advanced carcinoma of the head (26 cats) for a total of forty-seven cats treated. Electrochemotherapy is well tolerated for advanced SCC of the head in cats; its use can be considered among the locoregional strategies for cancer therapy in sensitive body regions such as the periocular region.

Spugnini EP, Pizzuto M, Filipponi M, Romani L, Vincenzi B, Menicagli F, Lanza A, De Girolamo R, Lomonaco R, Fanciulli M, Spriano G, Baldi A. Electroporation Enhances Bleomycin Efficacy in Cats with Periocular Carcinoma and Advanced Squamous Cell Carcinoma of the Head. J Vet Intern Med. 2015 Sep-Oct;29(5):1368-75. https://pubmed.ncbi.nlm.nih.gov/26192904/

Electrochemotherapy with cisplatin enhances local control after surgical ablation of fibrosarcoma in cats: an approach to improve the therapeutic index of highly toxic chemotherapy drugs

ECT is a safe and efficacious therapy for solid tumors; its use may be considered as part of strategies for the reintroduction of drugs with a narrow therapeutic index in the clinical protocols. In this study, a cohort of sixty-four cats with incompletely excised sarcomas were treated with cisplatin-based adjuvant ECT and monitored for side effects. Their response was compared to that of fourteen cats treated with surgery alone and the toxicities were minimal and mostly treated symptomatically. ECT resulted in increased local control with a mean time to recurrence of 666 days versus 180 of controls.

Spugnini EP, Renaud SM, Buglioni S, Carocci F, Dragonetti E, Murace R, Cardelli P, Vincenzi B, Baldi A, Citro G. Electrochemotherapy with cisplatin enhances local control after surgical ablation of fibrosarcoma in cats: an approach to improve the therapeutic index of highly toxic chemotherapy drugs. J Transl Med. 2011 Sep 14;9:152 https://pubmed.ncbi.nlm.nih.gov/21917133/

Adjuvant electrochemotherapy with bleomycin and cisplatin combination for canine soft tissue sarcomas: A study of 30 cases

Thirty dogs with incompletely excised canine soft tissue sarcomas (STSs) were enrolled. The dogs received intravenous bleomycin, and the tumor bed and margins were infiltrated with cisplatin. Then, trains of permeabilizing biphasic electric pulses were applied under sedation with the  electroporator. A second session was performed 2 wk later. The treatment was well tolerated and side effects were minimal. ECT using combination of bleomycin and cisplatin appears to be effective in the treatment of incompletely resected STSs in dogs. This therapeutic approach could be a useful addition to the current options in consideration of its low cost, limited toxicity, and ease of administration.

Spugnini EP, Vincenzi B, Amadio B, Baldi A. Adjuvant electrochemotherapy with bleomycin and cisplatin combination for canine soft tissue sarcomas: A study of 30 cases. Open Vet J. 2019 Apr;9(1):88-93.  https://pubmed.ncbi.nlm.nih.gov/31086772/

Electrochemotherapy for the treatment of cutaneous solid tumors in equids: A retrospective study

Electrochemotherapy (ECT) has recently been used in equine medicine to increase the chances of local control for cutaneous neoplasms of different nature, with good results.

Cancer is a source of morbidity and mortality in equines although it is not as crucial as companion animals. The lack of proper central recording systems prevents researchers from knowing the tumor incidence in equines. Up until now, the general consensus, generated from Universities caseloads and slaughterhouses registries, is that the inter-tegumentary apparatus is the most common site of neoplasia in equines. The predominant tumor types of the skin in equines, accounting for 95% of cutaneous neoplasms, are sarcoids, melanomas, and squamous cell carcinomas (SCC), while mesenchymal tumors such as fibrosarcoma (FSA) are infrequently reported.

This retrospective study, carried out by our research group, suggests that ECT may be beneficial for equids with solid neoplasms and could be a useful addition to the current therapeutic options considering its low cost, limited toxicity, and ease of administration. Sixteen equids were enrolled in this study and treated with the  veterinary electroporator. There were nine melanoma cases, four fibrosarcoma, and three squamous cell carcinoma.

Enrico P. Spugnini, Licia Scacco, Carlo Bolaffio, Alfonso Baldi, Electrochemotherapy for the treatment of cutaneous solid tumors in equids: A retrospective study, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8541726/

Isolated limb perfusion electrochemotherapy for the treatment of an advanced squamous cell carcinoma of the hoof in a mare

Another example of an equine case carried out by the Biopulse Biotech research group, is the story of a twenty-year-old female saddle horse. This mare was referred for evaluation of a seven month, non-healing erosive lesion of the right hind hoof with proliferation and bleeding of the underlying soft tissues. This lesion had been twice surgically treated as a canker but rapidly recurred. Histological examination of the second excision revealed a well-differentiated squamous cell carcinoma. At presentation, the horse was mildly depressed, lame and partially non-weight-bearing on the right hind leg, which exhibited a 10 x 10 cm erosive and proliferative lesion remodeling the hoof. After completing staging procedures, the lesion was approached with surgery and intraoperative Veterinary Electrochemotherapy (ECT) administration of bleomycin in isolated limb perfusion. A second session of surgery and ECT was performed one month later, followed by three additional monthly sessions of ECT. One year after presentation, the mare was in complete remission and her gait markedly improved.

Spugnini EP, Bolaffio C, Scacco L, Baldi A. Isolated limb perfusion electrochemotherapy for the treatment of an advanced squamous cell carcinoma of the hoof in a mare. Open Vet J. 2017;7(2):192-196. Doi: 10.4314/ovj.v7i2.18. Epub 2017 Jun 28. PubMed PMID: 28717603; PubMed Central PMCID: PMC5498771, https://pubmed.ncbi.nlm.nih.gov/28717603/

Surgery and electrochemotherapy for the treatment of cutaneous squamous cell carcinoma in a yellow-bellied slider (Trachemys scripta scripta)

Based on the experience of our research group, Veterinary Electrochemotherapy (ECT) should be considered as a possible postsurgical adjuvant treatment also in reptiles with cutaneous tumors.

In this case, a 5-year-old female yellow-bellied slider (Trachemys scripta scripta) was referred for evaluation of a 2-month nonhealing ulcerated mass on the dorsal aspect of the neck. The turtle was quiet, alert, and responsive, with a 2 ×1.5 cm ulcerated lesion on the neck. Following total body radiography and hematologic and serum biochemical analysis, the turtle was anesthetized and the mass was surgically removed. The excised tissue was submitted for histologic evaluation. A histopathologic diagnosis of squamous cell carcinoma (SCC) was made. The tumor bed was treated with electrochemotherapy (ECT) with electroporator. Two sessions of ECT were performed with a 2-week interval between treatments. Electrochemotherapy involved intratumoral administration of bleomycin followed by trains of biphasic electric pulses. The treatment was well tolerated, and the turtle was disease free after 12 months.

Lanza A, Baldi A, Spugnini EP. Surgery and electrochemotherapy for the treatment of cutaneous squamous cell carcinoma in a yellow-bellied slider (Trachemys scripta scripta). J Am Vet Med Assoc. 2015 Feb 15;246(4):455-7. Doi:10.2460/javma.246.4.455. PubMed PMID:25632821, https://pubmed.ncbi.nlm.nih.gov/25632821/

Electrochemotherapy for the treatment of an incompletely excised subcutaneous low-grade epithelioid hemangioendothelioma in a budgerigar parakeet

Cutaneous tumors are rarely described in avian and are frequently of viral origin. Solid tumors of vascular origin are seldom reported and usually result in difficult management by surgery alone. We describe the outcome of a subcutaneous low-grade epithelioid hemangioendothelioma (EHE) treated with the combination of surgery and electrochemotherapy. In lieu of the incomplete surgical excision of the tumor, veterinary electrochemotherapy (ECT)  resulted in good local control and cosmetic appearance and should be added to the standard oncological therapies for avian. An interesting case, treated with the veterinary electroporator, is that of a 10-year-old male budgerigar parakeet (Melopsittacus undulatus) was referred for evaluation of a 2-month non-healing exophytic mass on the left wing. The bird was bright, alert, and responsive, with a 2 × 1 cm proliferative lesion on the wing. Signs of discomfort were elicited by the clinical manipulation of the wing; no other abnormalities were detected during physical evaluation. Following hematological and imaging analysis, the parakeet was anesthetized and the mass was surgically removed. The histopathology report came back with a diagnosis of incompletely excised subcutaneous low-grade EHE. A surgical revision was not feasible due to the anatomical location and tumor extension. Adjuvant electrochemotherapy was chosen to increase the chance of tumor control. Two sessions of electrochemotherapy were performed with a 2-week interval between treatments using intralesional bleomycin followed by trains of permeabilizing electric pulses. Side effects were not observed and the parakeet was disease-free for 12 months when he died of acute renal failure.

Lanza A., Baldi A., Rossi G., Spugnini EP., Electrochemotherapy for the treatment of an incompletely excised subcutaneous low-grade epithelioid hemangioendothelioma in a budgerigar parakeet (Melopsittacus 2ndulates), Open Veterinary Journal, (2019), Vol.9(3): 269–272, DOI: http://dx.doi.org/10.4314/ovj.v9i3.13 ,September 2019, https://pubmed.ncbi.nlm.nih.gov/31998622/