European Institute of Oncology (IEO-IRCCS), Milan, Lombardy, Italy.
Curr Opin Oncol. 2012 Mar;24(2):155-61. doi: 10.1097/CCO.0b013e32834fcaa8.
In the present study, the role of electrochemotherapy (ECT) in the advanced melanoma setting, either as alternative treatment modality to conventional therapies or as palliative care, is reviewed and the perspective to combine ECT with biological response modifiers and immunotherapeutic compounds is discussed.
ECT refers to the combination of electroporation and administration of anticancer drugs for local treatment of solid neoplasms. Electroporation uses short and intense electric pulses to induce a transient permeabilization of the cell membrane by creation of pores, thus allowing molecules, such as chemotherapeutic agents, to freely diffuse into the cytosol. ECT has shown to be effective and clinically well tolerated in the local control of primary and metastatic solid tumors of diverse histotypes in preclinical and clinical studies, thus, emerging as useful local treatment modality for disseminated superficial melanoma. So far, only a few data on the role of immunological response in ECT-treated patients have been reported.
Treatment regimens combining ECT to biological response modifiers (interleukin-2, interferon) and immunotherapeutic compounds should be further explored in animal and human cancer models; immunotherapy combined to ECT could broaden the therapeutic indications of ECT, by rendering it effective also on distant unreachable or untreated lesions.
在本研究中,综述了电化学疗法(ECT)在晚期黑色素瘤治疗中的作用,包括作为传统治疗方法的替代疗法或姑息治疗,以及讨论了将 ECT 与生物反应调节剂和免疫治疗化合物联合应用的前景。
ECT 是指电穿孔和抗癌药物联合用于局部治疗实体瘤的方法。电穿孔通过形成孔使细胞膜短暂可逆地通透,从而允许分子(如化疗药物)自由扩散到细胞质中,以此增强抗癌药物的细胞内摄取。在临床前和临床研究中,ECT 已被证明在原发性和转移性多种组织学类型的实体肿瘤的局部控制方面是有效且临床耐受良好的,因此,作为一种有前途的局部治疗方法,正在被用于治疗播散性浅表性黑色素瘤。到目前为止,只有少数关于 ECT 治疗患者免疫反应作用的数据被报道。
应进一步在动物和人类癌症模型中探索将 ECT 与生物反应调节剂(白细胞介素-2、干扰素)和免疫治疗化合物联合应用的治疗方案;免疫疗法与 ECT 的联合应用可以通过使其对远处无法触及或未经治疗的病变也有效,从而扩大 ECT 的治疗适应证。