Projects / Programmes
Electrochemotherapy in treatment of deep seated tumors
| Code |
Science |
Field |
Subfield |
| 3.04.00 |
Medical sciences |
Oncology |
|
| Code |
Science |
Field |
| B200 |
Biomedical sciences |
Cytology, oncology, cancerology |
| Code |
Science |
Field |
| 3.02 |
Medical and Health Sciences |
Clinical medicine |
electrochemotherapy; liver metastases; colorectal cancer
Researchers (18)
Organisations (2)
Abstract
The proposed project is aimed at developing and refining electrochemotherapy (ECT) as a novel intraoperative treatment approach for liver metastases, as well as primary liver tumors, which are found to be in difficult-to-treat locations or are untreatable with other standard ablation techniques. Based on the effectiveness of the method per se and experiences gained, indications and guidelines for ECT in the treatment of liver tumors will be prepared.
ECT is a local treatment that combines application of electric pulses to increase the uptake of cytotoxic drugs, such as bleomycin and cisplatin, into tumor cells. ECT has already been implemented as palliative treatment of skin melanoma metastases, but is also effective in treatment of other cutaneous and subcutaneous nodules regardless of their histological origin. The objective response rate of the ECT-treated nodules is 80% and long lasting complete response rate is 70%. However, ECT needs translation into treatment of bigger (≥ 3 cm in diameter) and deep-seated tumors with the technological adaptation of the procedure and verification of its safety and effectiveness.
In our first case of deep-seated melanoma tumor in the thigh the feasibility of ECT in such conditions was demonstrated. In the frame of our Phase I clinical trial we recently described the first efficient ECT of unresectable colorectal liver metastasis. Based on these first experiences ECT proved to be safe, but needs to be evaluated for effectiveness on more patients with colorectal liver metastases. In addition, in the project ECT is foreseen in the treatment of liver metastases of other histologies than colorectal cancer and also of primary liver tumors. The advantage of ECT will be predominantly in difficult-to-treat locations, where other ablation techniques would not have been effective.
Therefore, protocols for clinical trials will be designed and executed for treatment of both, liver metastases and primary liver tumors. In general, the treatment will be performed based on the preliminary experiences of ECT performed on colorectal liver metastases. In particular, for individual patient with a tumor at a difficult-to-treat location the treatment plan based on numerical modeling will be implemented according to radiological examination of the tumor topography. Long needle electrodes will be positioned into the tumor and its vicinity to cover also safety margins in accordance with the treatment plan based on numerical modeling. Besides such electrodes, also electrodes with fixed geometries will be used for treatment of smaller (≤3 cm in diameter) tumors in easier-to-reach locations, which do not need a treatment plan based on numerical modeling. Regardless of the position of the tumor and the electrodes used, the delivery of electric pulses will be synchronized with the heartbeat in order to avoid delivery of pulses within vulnerable period. Various radiologic imaging techniques will be used for evaluation of biological/functional characteristics of the tumors in order to find the most suitable technique for early prediction of the tumor response and for evaluation of its late response to ECT.
Expected results will be in the clinical and technological domain. Based on the effectiveness of ECT in the treatment of skin tumors we expect good response rate of liver tumors. In regards to this, indications for ECT in treatment of liver tumors will be set, specifically in respect to standard ablation techniques. This project will demonstrate feasibility, safety and effectiveness of ECT for its translation into broader clinical use also for treatment of other abdominal tumors.
Significance for science
The study has brought an important technological contribution to the development of ECT. It is the first study of treatment of deep-lying tumors in the liver. Therefore, this is a milestone in the development of this technology. Additionally, the rest of technological development is important, which was developed within the study: from planning the electrode positioning to the radiological evaluation of early and late changes in tumors and to the synchronization of electrical pulse application to the heart rhythm.
Significance for the country
The study has two implications for the development of Slovenia: well-being of patients with the help of new technology and international recognition of Slovenian science as the leading in biomedical applications of electroporation.
Most important scientific results
Annual report
2013,
2014,
2015,
final report
Most important socioeconomically and culturally relevant results
Annual report
2013,
2014,
2015,
final report
