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Cancers
Special Issues
Electrochemotherapy as Treatment for Head and Neck Tumors
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Electrochemotherapy as Treatment for Head and Neck Tumors

A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 11844

Special Issue Editors

Dr. Francesco Longo

E-Mail Website1 Website2
Guest Editor
1. Hospital “Casa Sollievo della Sofferenza” IRCCS – San Giovanni Rotondo, Foggia, Italy
2. Istituto Nazionale Tumori IRCCS - Fondazione G Pascale, Napoli, Naples, Italy
Interests: head and neck surgery and oncology; maxillo-facial surgery; otolaryngology; salivary glands; oral cancer; skin tumors; larynx surgery; innovative treatments; reconstructive and regenerative surgery; electrochemotherapy
Dr. Barbara Pichi

E-Mail Website
Guest Editor
National Cancer Institute Regina Elena” IRCCS, Roma, Rome, Italy
Interests: Head and Neck Surgery; Otolaryngology; Reconstructive Surgery; Electrochemotherapy
Dr. Francesco Perri

E-Mail Website
Guest Editor
Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, Via Mariano Semmola, 80131 Napoli, Italy
Interests: head and neck oncology; immune-therapy; targeted therapy; pain therapy; electrochemotherapy; cancer diagnostics; treatment tumors; cancer biology; cancer biomarkers; tumor biology cancer; cell biology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Electrochemotherapy is a treatment combining a low dose of antineoplastic drug (bleomycin) and an electrical pulse (electroporation) applied directly to the cancer cells using an electrode. Electroporation consists of the application of short, intense, pulsed electric fields to tumor cells, with a transient increase of membrane permeability, facilitating cellular uptake of cytotoxic agents and increasing their toxicity.

Electrochemotherapy is indicated for the local treatment of solid tumors; it is a well-established antitumor strategy for cutaneous neoplasms and has interesting applications for the treatment of head and neck tumors. In fact, it is effective with any tumor regardless of the histotype and has several mechanisms of action with vascular and immunologic effects, ensuring good control of bleeding lesions and interesting prospects for the general care of cancer patients.

The interest in electrochemotherapy for the treatment of tumors in the head and neck area has increased because it results in minimal or no impacts to function and can lead to healing of treated tumor lesions without damage to the healthy tissues.

For these reasons, electrochemotherapy can be an alternative to palliative chemotherapy or radiotherapy, and partial and complete remission rates have been reported in various clinical trials with a low frequency of side effects. Electrochemotherapy is well tolerated and leads to a significant improvement of quality of life, including in elderly patients.

This Special Issue of Cancers will highlight the role of electrochemotherapy and its applications in the treatment of head and neck tumors.

For this Special Issue, we particularly welcome authors to submit original articles and reviews underlining every possible indication (curative, palliative, etc.) to establish its current use and future prospects.

Dr. Francesco Longo
Dr. Barbara Pichi
Dr. Francesco Perri
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at mdpi.longhoe.net by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • electrochemotherapy
  • head and neck tumors
  • palliative treatment
  • electroporation
  • innovative treatment

Published Papers (4 papers)

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Research

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11 pages, 720 KiB  
Communication
Boosting the Immune Response with the Combination of Electrochemotherapy and Immunotherapy: A New Weapon for Squamous Cell Carcinoma of the Head and Neck?
by Francesco Longo, Francesco Perri, Francesco Caponigro, Giuseppina Della Vittoria Scarpati, Agostino Guida, Ettore Pavone, Corrado Aversa, Paolo Muto, Mario Giuliano, Franco Ionna and Raffaele Solla
Cancers 2020, 12(10), 2781; https://doi.org/10.3390/cancers12102781 - 28 Sep 2020
Cited by 16 | Viewed by 2438
Abstract
Head and neck squamous cell carcinomas (SCCHN) are not rare malignancies and account for 7% of all solid tumors. Prognosis of SCCHN patients strongly depends on tumor extension, site of onset, and genetics. Advanced disease (recurrent/metastatic) is associated with poor prognosis, with a [...] Read more.
Head and neck squamous cell carcinomas (SCCHN) are not rare malignancies and account for 7% of all solid tumors. Prognosis of SCCHN patients strongly depends on tumor extension, site of onset, and genetics. Advanced disease (recurrent/metastatic) is associated with poor prognosis, with a median overall survival of 13 months. In these patients, immunotherapy may represent an interesting option of treatment, given the good results reached by check-point inhibitors in clinical practice. Nevertheless, only a minor number of patients with advanced disease respond to immunotherapy, and, disease progressions/hyper-progressions are common. The latter could be a very difficult issue, especially in patients having a wide and highly symptomatic head/neck mass. Given the potentiality to boost the immune response of some local modalities, such as electrochemotherapy, a possible future approach may take into account the combination of electrochemotherapy and immunotherapy to treat patients affected by SCCHN, suffering from symptomatic lesions that need rapid debulking. Full article
(This article belongs to the Special Issue Electrochemotherapy as Treatment for Head and Neck Tumors)
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Review

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28 pages, 3566 KiB  
Review
Electroporation in Head-and-Neck Cancer: An Innovative Approach with Immunotherapy and Nanotechnology Combination
by Silvia Pisani, Giulia Bertino, Adriele Prina-Mello, Laura Deborah Locati, Simone Mauramati, Ida Genta, Rossella Dorati, Bice Conti and Marco Benazzo
Cancers 2022, 14(21), 5363; https://doi.org/10.3390/cancers14215363 - 31 Oct 2022
Cited by 10 | Viewed by 2846
Abstract
Squamous cell carcinoma is the most common malignancy that arises in the head-and-neck district. Traditional treatment could be insufficient in case of recurrent and/or metastatic cancers; for this reason, more selective and enhanced treatments are in evaluation in preclinical and clinical trials to [...] Read more.
Squamous cell carcinoma is the most common malignancy that arises in the head-and-neck district. Traditional treatment could be insufficient in case of recurrent and/or metastatic cancers; for this reason, more selective and enhanced treatments are in evaluation in preclinical and clinical trials to increase in situ concentration of chemotherapy drugs promoting a selectively antineoplastic activity. Among all cancer treatment types (i.e., surgery, chemotherapy, radiotherapy), electroporation (EP) has emerged as a safe, less invasive, and effective approach for cancer treatment. Reversible EP, using an intensive electric stimulus (i.e., 1000 V/cm) applied for a short time (i.e., 100 μs), determines a localized electric field that temporarily permealizes the tumor cell membranes while maintaining high cell viability, promoting cytoplasm cell uptake of antineoplastic agents such as bleomycin and cisplatin (electrochemotherapy), calcium (Ca2+ electroporation), siRNA and plasmid DNA (gene electroporation). The higher intracellular concentration of antineoplastic agents enhances the antineoplastic activity and promotes controlled tumor cell death (apoptosis). As secondary effects, localized EP (i) reduces the capillary blood flow in tumor tissue (“vascular lock”), lowering drug washout, and (ii) stimulates the immune system acting against cancer cells. After years of preclinical development, electrochemotherapy (ECT), in combination with bleomycin or cisplatin, is currently one of the most effective treatments used for cutaneous metastases and primary skin and mucosal cancers that are not amenable to surgery. To reach this clinical evidence, in vitro and in vivo models were preclinically developed for evaluating the efficacy and safety of ECT on different tumor cell lines and animal models to optimize dose and administration routes of drugs, duration, and intensity of the electric field. Improvements in reversible EP efficacy are under evaluation for HNSCC treatment, where the focus is on the development of a combination treatment between EP-enhanced nanotechnology and immunotherapy strategies. Full article
(This article belongs to the Special Issue Electrochemotherapy as Treatment for Head and Neck Tumors)
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20 pages, 827 KiB  
Review
Electrochemotherapy in the Treatment of Head and Neck Cancer: Current Conditions and Future Directions
by Tomohiro Enokida and Makoto Tahara
Cancers 2021, 13(6), 1418; https://doi.org/10.3390/cancers13061418 - 19 Mar 2021
Cited by 13 | Viewed by 3231
Abstract
Despite recent advances in the development of chemotherapeutic drug, treatment for advanced cancer of the head and neck cancer (HNC) is still challenging. Options are limited by multiple factors, such as a prior history of irradiation to the tumor site as well as [...] Read more.
Despite recent advances in the development of chemotherapeutic drug, treatment for advanced cancer of the head and neck cancer (HNC) is still challenging. Options are limited by multiple factors, such as a prior history of irradiation to the tumor site as well as functional limitations. Against this background, electrochemotherapy (ECT) is a new modality which combines administration of an antineoplastic agent with locally applied electric pulses. These pulses allow the chemotherapeutic drug to penetrate the intracellular space of the tumor cells and thereby increase its cytotoxicity. ECT has shown encouraging efficacy and a tolerable safety profile in many clinical studies, including in heavily pre-treated HNC patients, and is considered a promising strategy. Efforts to improve its efficacy and broaden its application are now ongoing. Moreover, the combination of ECT with recently developed novel therapies, including immunotherapy, represented by immune checkpoint inhibitor (ICI)s, has attracted attention for its potent theoretical rationale. More extensive, well-organized clinical studies and timely updating of consensus guidelines will bring this hopeful treatment to HNC patients under challenging situations. Full article
(This article belongs to the Special Issue Electrochemotherapy as Treatment for Head and Neck Tumors)
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Other

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14 pages, 834 KiB  
Study Protocol
Electrochemotherapy as a First Line Treatment in Recurrent Squamous Cell Carcinoma of the Oral Cavity and Oropharynx PDL-1 Negative and/or with Evident Contraindication to Immunotherapy: A Randomized Multicenter Controlled Trial
by Francesco Perri, Francesco Longo, Roberta Fusco, Valeria D’Alessio, Corrado Aversa, Ettore Pavone, Monica Pontone, Maria Luisa Marciano, Salvatore Villano, Pierluigi Franco, Giulia Togo, Gianluca Renato De Fazio, Daniele Ordano, Fabio Maglitto, Giovanni Salzano, Maria Grazia Maglione, Agostino Guida and Franco Ionna
Cancers 2021, 13(9), 2210; https://doi.org/10.3390/cancers13092210 - 4 May 2021
Cited by 6 | Viewed by 2251
Abstract
Background: A significant proportion of patients with head and neck squamous cell carcinoma (HNSCC) have advanced-stage disease (stages III to IVB) that do not respond to therapy despite aggressive, site-specific multimodality therapy. A great number of them will develop disease recurrence, with up [...] Read more.
Background: A significant proportion of patients with head and neck squamous cell carcinoma (HNSCC) have advanced-stage disease (stages III to IVB) that do not respond to therapy despite aggressive, site-specific multimodality therapy. A great number of them will develop disease recurrence, with up to 60% risk of local failure and up to 30% risk of distant failure. Therapy can be very demanding for the patient especially when important anatomical structures are involved. For these reasons, therapies that preserve organ functionality in combination with effective local tumor control, like electrochemotherapy (ECT), are of great interest. Until few months ago, systemic cetuximab + platinum-based therapy + 5-fluorouracil represented the standard treatment for HNSCC relapses with a median overall survival of 10.1 months and an objective response rate of 36%. Recently the results of KEYNOTE-048 study were published and a new combination of monoclonal antibody named pembrolizumab and chemotherapy emerged as standard first line therapy of recurrent or metastatic tumor that overexpress tissue PDL-1 (Programmed Death 1 ligand). Nevertheless, a variable percentage from 10 to 15% of patients with recurrent/metastatic disease have a tumor that does not overexpress tissue PDL-1, and therefore, according to the results of the KEYNOTE-048 study, does not benefit from replacement of cetuximab with pembrolizumab. These patients will be treated with the “gold standard”: cetuximab, cisplatin/carboplatin and 5-fluorouracil. Aim: To verify whether electrochemotherapy performed with bleomycin of HNSCC relapses of the oral cavity and oropharynx (single relapse on T) is able to lead to an increase in the objective response rate in comparison with the systemic treatment with cetuximab + platinum-based therapy + 5-fluorouracil in patients with PDL-1 negative tumors. Methods: The phase IIb study involves the enrolment of 96 patients who meet the inclusion criteria (48 in the control arm and 48 in the treatment arm). The control arm involves the treatment of HNSCC with systemic treatment (cetuximab + platinum-based therapy + 5-fluorouracil). The treatment arm involves the ECT with bleomycin. The primary objective is to verify the objective response rate of patients in the control arm compared to the treatment arm. Full article
(This article belongs to the Special Issue Electrochemotherapy as Treatment for Head and Neck Tumors)
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