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Groselj A, Kranjc S, Bosnjak M, Krzan M, Kosjek T, Prevc A, Cemazar M, Sersa G. Vascularization of the tumours affects the pharmacokinetics of bleomycin and the effectiveness of electrochemotherapy. Basic Clin Pharmacol Toxicol 2018; 123:247-256. [DOI: 10.1111/bcpt.13012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/12/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Ales Groselj
- Department of Otorhinolaryngology and Cervicofacial Surgery; University Medical Centre Ljubljana; Ljubljana Slovenia
- Faculty of Medicine; University of Ljubljana; Ljubljana Slovenia
| | - Simona Kranjc
- Department of Experimental Oncology; Institute of Oncology Ljubljana; Ljubljana Slovenia
| | - Masa Bosnjak
- Department of Experimental Oncology; Institute of Oncology Ljubljana; Ljubljana Slovenia
| | - Mojca Krzan
- Faculty of Medicine; Department of Pharmacology and Experimental Toxicology; University of Ljubljana; Ljubljana Slovenia
| | - Tina Kosjek
- Department of Environmental Sciences; Jozef Stefan Institute; Ljubljana Slovenia
| | - Ajda Prevc
- Department of Experimental Oncology; Institute of Oncology Ljubljana; Ljubljana Slovenia
| | - Maja Cemazar
- Department of Experimental Oncology; Institute of Oncology Ljubljana; Ljubljana Slovenia
- Faculty of Health Sciences; University of Primorska; Izola Slovenia
| | - Gregor Sersa
- Department of Experimental Oncology; Institute of Oncology Ljubljana; Ljubljana Slovenia
- Faculty of Health Sciences; University of Ljubljana; Ljubljana Slovenia
- Faculty of Health Sciences; University of Primorska; Izola Slovenia
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2
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Bimonte S, Leongito M, Granata V, Barbieri A, Del Vecchio V, Falco M, Nasto A, Albino V, Piccirillo M, Palaia R, Amore A, Giacomo RD, Lastoria S, Setola SV, Fusco R, Petrillo A, Izzo F. Electrochemotherapy in pancreatic adenocarcinoma treatment: pre-clinical and clinical studies. Radiol Oncol 2016; 50:14-20. [PMID: 27069445 PMCID: PMC4825336 DOI: 10.1515/raon-2016-0003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 12/13/2015] [Indexed: 12/18/2022] Open
Abstract
Background Pancreatic adenocarcinoma is currently one of the deadliest cancers with high mortality rate. This disease leads to an aggressive local invasion and early metastases, and is poorly responsive to treatment with chemotherapy or chemo-radiotherapy. Radical resection is still the only curative treatment for pancreatic cancer, but it is generally accepted that a multimodality strategy is necessary for its management. Therefore, new alternative therapies have been considered for local treatment. Conclusions Chemotherapeutic resistance in pancreatic cancer is associated to a low penetration of drugs into tumour cells due to the presence of fibrotic stroma surrounding cells. In order to increase the uptake of chemotherapeutic drugs into tumour cells, electrochemotherapy can be used for treatment of pancreatic adenocarcinoma leading to an increased tumour response rate. This review will summarize the published papers reported in literature on the efficacy and safety of electrochemotherapy in pre-clinical and clinical studies on pancreatic cancer.
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Affiliation(s)
- Sabrina Bimonte
- Division of Abdominal Surgical Oncology, Hepatobiliary Unit, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - Maddalena Leongito
- Division of Abdominal Surgical Oncology, Hepatobiliary Unit, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - Antonio Barbieri
- S.S.D Sperimentazione Animale, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - Vitale Del Vecchio
- S.S.D Sperimentazione Animale, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - Michela Falco
- S.S.D Sperimentazione Animale, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - Aurelio Nasto
- Division of Abdominal Surgical Oncology, Hepatobiliary Unit, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - Vittorio Albino
- Division of Abdominal Surgical Oncology, Hepatobiliary Unit, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - Mauro Piccirillo
- Division of Abdominal Surgical Oncology, Hepatobiliary Unit, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - Raffaele Palaia
- Division of Abdominal Surgical Oncology, Hepatobiliary Unit, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - Alfonso Amore
- Division of Abdominal Surgical Oncology, Hepatobiliary Unit, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - Raimondo di Giacomo
- Division of Abdominal Surgical Oncology, Hepatobiliary Unit, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - Secondo Lastoria
- Division of Nuclear Medicine, Department of Diagnostic Imaging and Radiotherapy, Istituto Nazionale Tumori "Fondazione G.Pascale" IRCCS, Naples, Italy
| | - Sergio Venanzio Setola
- Division of Radiology, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - Roberta Fusco
- Division of Radiology, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - Antonella Petrillo
- Division of Radiology, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - Francesco Izzo
- Division of Abdominal Surgical Oncology, Hepatobiliary Unit, Istituto Nazionale per lo studio e la cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy
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Girelli R, Prejanò S, Cataldo I, Corbo V, Martini L, Scarpa A, Claudio B. Feasibility and safety of electrochemotherapy (ECT) in the pancreas: a pre-clinical investigation. Radiol Oncol 2015; 49:147-54. [PMID: 26029026 PMCID: PMC4387991 DOI: 10.1515/raon-2015-0013] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Accepted: 02/12/2015] [Indexed: 12/13/2022] Open
Abstract
Background. Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease generally refractory to standard chemotherapeutic agents; therefore improvements in anticancer therapies are mandatory. A major determinant of therapeutic resistance in PDAC is the poor drug delivery to neoplastic cells, mainly due to an extensive fibrotic reaction. Electroporation can be used in vivo to increase cancer cells’ local uptake of chemotherapeutics (electrochemotherapy, ECT), thus leading to an enhanced tumour response rate. In the present study, we evaluated the in vivo effects of reversible electroporation in normal pancreas in a rabbit experimental model. We also tested the effect of electroporation on pancreatic cancer cell lines in order to evaluate their increased sensitivity to chemotherapeutic agents. Materials and methods. The application in vivo of the European Standard Operating Procedure of Electrochemotherapy (ESOPE) pulse protocol (1000 V/cm, 8 pulses, 100 μs, 5 KHz) was tested on the pancreas of normal New Zealand White Rabbits and short and long-term toxicity were assessed. PANC1 and MiaPaCa2 cell lines were tested for in vitro electrochemotherapy experiments with and without electroporation. Levels of cell permeabilization were determined by flow cytometry, whereas cell viability and drug (cisplatin and bleomycin) sensitivity of pulsed cells were measured by 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay. Results. In healthy rabbits, neither systemic nor local toxic effects due to the electroporation procedure were observed, demonstrating the safety of the optimized electric parameters in the treatment of the pancreas in vivo. In parallel, we established an optimized protocol for ECT in vitro that determined an enhanced anti-cancer effect of bleomycin and cisplatin with respect to treatment without electroporation. Conclusions. Our data suggest that electroporation is a safe procedure in the treatment of PDAC because it does not affect normal pancreatic parenchyma, but has a potentiating effect on cytotoxicity of bleomycin in pancreatic tumour cell lines. Therefore, ECT could be considered as a valid alternative for the local control of non-resectable pancreatic cancer.
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Affiliation(s)
- Roberto Girelli
- Pancreatic Unit - Casa di Cura Pederzoli, Peschiera del Garda (VR), Italy
| | - Simona Prejanò
- ARC-NET Research Centre and Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
| | - Ivana Cataldo
- ARC-NET Research Centre and Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
| | - Vincenzo Corbo
- ARC-NET Research Centre and Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
| | - Lucia Martini
- Laboratory of Preclinical and Surgical Studies and Laboratory of Biocompatibility, Innovative Technologies and Advanced Therapies, Rizzoli Orthopedic Institute Bologna, Italy
| | - Aldo Scarpa
- ARC-NET Research Centre and Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
| | - Bassi Claudio
- Department of Surgery and Oncology, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy
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Cury FL, Bhindi B, Rocha J, Scarlata E, El Jurdi K, Ladouceur M, Beauregard S, Vijh AK, Taguchi Y, Chevalier S. Electrochemical red-ox therapy of prostate cancer in nude mice. Bioelectrochemistry 2014; 104:1-9. [PMID: 25578541 DOI: 10.1016/j.bioelechem.2014.12.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 12/16/2014] [Accepted: 12/17/2014] [Indexed: 11/30/2022]
Abstract
Minimally invasive therapies are increasingly in demand for organ-confined prostate tumors. Electrochemical therapy (EChT) is attractive, as it relies on locally-induced reduction-oxidation reactions to kill tumor cells. Its efficacy for prostate cancer was assessed in human PC-3 and LNCaP tumor xenografts growing subcutaneously in nude mice (n = 80) by applying 2 Stainless Steel vs. 4 Platinum-Iridium (Pt-Ir) electrodes to deliver current densities of 10 to 35 mA/cm(2) for 30 or 60 min. The procedure was uneventful in 90% of mice. No difference in tumor vs. body temperature was observed. Changes at electrode-tumor junctions were immediate, with dryness and acidity (pH2-3) at the anode and oedema and alkalinity (pH10-12) at the cathode. This was accompanied by cellular alterations, found more pronounced at the cathode. Such acidic and alkaline conditions were cytotoxic in vitro and dissolved cells at pH>10. In mice, tumor destruction was extensive by 24h with almost undetectable blood prostate specific antigen (LNCaP model) and covered the whole tumor surface by 4 days. EChT was most efficient at 25-30 mA/cm(2) for 60 min, yielding the longest recurrence-free survival and higher cure rates, especially with 4 Pt-Ir electrodes. EChT is a promising option to optimize for organ-confined prostate tumors.
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Affiliation(s)
- Fabio L Cury
- Urologic-Oncology Research Laboratory, McGill University Health Center Research Institute, Montreal, Quebec, Canada; Division of Radiation Oncology, McGill University Health Center, Montreal, Quebec, Canada
| | - Bimal Bhindi
- Division of Urology, University of Toronto, Toronto, Ontario, Canada
| | - Joice Rocha
- Urologic-Oncology Research Laboratory, McGill University Health Center Research Institute, Montreal, Quebec, Canada
| | - Eleonora Scarlata
- Urologic-Oncology Research Laboratory, McGill University Health Center Research Institute, Montreal, Quebec, Canada
| | - Katia El Jurdi
- Urologic-Oncology Research Laboratory, McGill University Health Center Research Institute, Montreal, Quebec, Canada
| | - Michel Ladouceur
- Institut de Recherche d'Hydro Québec (IREQ), Varennes, Quebec, Canada
| | | | - Ashok K Vijh
- Institut de Recherche d'Hydro Québec (IREQ), Varennes, Quebec, Canada
| | - Yosh Taguchi
- Division of Urology, Dept. of Surgery, McGill University, Montreal, Quebec, Canada
| | - Simone Chevalier
- Urologic-Oncology Research Laboratory, McGill University Health Center Research Institute, Montreal, Quebec, Canada; Division of Urology, Dept. of Surgery, McGill University, Montreal, Quebec, Canada.
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Jarm T, Ĉmazˆar M, Serŝa G, Miklavĉiĉ D. Blood Perfusion in a Murine Fibrosarcoma Tumor Model After Direct Current Electrotherapy a Study with86Rb Extraction Technique. ACTA ACUST UNITED AC 2009. [DOI: 10.3109/15368379809022572] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Huang L, Xie Y, William Lown J. Section Review Oncologic, Endocrine & Metabolic: Bleomycin antibiotics and their role in cancer chemotherapy. Expert Opin Ther Pat 2008. [DOI: 10.1517/13543776.6.9.893] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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8
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Colombo L, González G, Marshall G, Molina FV, Soba A, Suarez C, Turjanski P. Ion transport in tumors under electrochemical treatment: in vivo, in vitro and in silico modeling. Bioelectrochemistry 2007; 71:223-32. [PMID: 17689151 DOI: 10.1016/j.bioelechem.2007.07.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2006] [Revised: 06/14/2007] [Accepted: 07/06/2007] [Indexed: 11/24/2022]
Abstract
The electrochemical treatment of cancer (EChT) consists in the passage of a direct electric current through two or more electrodes inserted locally in the tumor tissue. The extreme pH changes induced have been proposed as the main tumor destruction mechanism. Here, we study ion transport during EChT through a combined modeling methodology: in vivo modeling with BALB/c mice bearing a subcutaneous tumor, in vitro modeling with agar and collagen gels, and in silico modeling using the one-dimensional Nernst-Planck and Poisson equations for ion transport in a four-ion electrolyte. This combined modeling approach reveals that, under EChT modeling, an initial condition with almost neutral pH evolves between electrodes into extreme cathodic alkaline and anodic acidic fronts moving towards each other, leaving the possible existence of a biological pH region between them; towards the periphery, the pH decays to its neutral values. pH front tracking unveils a time scaling close to t(1/2), signature of a diffusion-controlled process. These results could have significant implications in EChT optimal operative conditions and dose planning, in particular, in the way in which the evolving EChT pH region covers the active cancer cells spherical casket.
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Affiliation(s)
- L Colombo
- Depto. de Inmunobiología, Inst. de Oncología Angel H. Roffo, Universidad de Buenos Aires, (C1417DTB) Buenos Aires, Argentina
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Ghannam MM, El-Gebaly RH, Gaber MH, Ali FM. INHIBITION OF EHRLICH TUMOR GROWTH IN MICE BY ELECTRIC INTERFERENCE THERAPY (IN VIVO STUDIES). Electromagn Biol Med 2002. [DOI: 10.1081/jbc-120015999] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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10
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Jaroszeski MJ, Coppola D, Pottinger C, Benson K, Gilbert RA, Heller R. Treatment of hepatocellular carcinoma in a rat model using electrochemotherapy. Eur J Cancer 2001; 37:422-30. [PMID: 11239766 DOI: 10.1016/s0959-8049(00)00412-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The effectiveness of antineoplastic agents has been augmented by applying pulsed electric fields directly to tumours after the administration of the drug. This treatment, known as electrochemotherapy (ECT), has been successful for cutaneous malignancies in animal models and in recent clinical trials. This study was aimed at investigating the applicability of ECT in a surgical setting for hepatocellular carcinomas induced in the livers of rats. Established tumours were injected with bleomycin, and electric pulses were then administered locally. Animals were followed based on tumour volumes and histological samples. Dose response data were obtained for both electric field intensity and bleomycin. Complete response rates for animals treated with electrochemotherapy ranged from 26.67% to 93.33 and were durable. In contrast, tumours that received no treatment, pulses only or drug only responded minimally. This supports the feasibility of using a ECT as a modality for treating hepatocellular carcinoma.
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Affiliation(s)
- M J Jaroszeski
- Department of Surgery, MDC Box 16, College of Medicine, University of South Florida, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612-4799, USA.
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Jarm T, Wickramasinghe YA, Deakin M, Cemazar M, Elder J, Rolfe P, Sersa G, Miklavcic D. Blood perfusion of subcutaneous tumours in mice following the application of low-level direct electric current. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2000; 471:497-506. [PMID: 10659183 DOI: 10.1007/978-1-4615-4717-4_59] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Electrotherapy with low-level direct electric current has been proved to be an effective local treatment of solid tumours. In the presented study an attempt was made to evaluate the effect of a single treatment with electrotherapy on blood perfusion of solid subcutaneous fibrosarcoma Sa-1 tumours in A/J mice. The tissue-staining method with Patent blue-violet dye, the rubidium extraction technique, and the noninvasive near-infrared spectroscopy method were used for this purpose. Results of all methods indicate that perfusion and subsequently oxygenation of tumours were reduced due to application of electrotherapy.
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Affiliation(s)
- T Jarm
- Faculty of Electrical Engineering, University of Ljubljana, Slovenia
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Nilsson E, von Euler H, Berendson J, Thörne A, Wersäll P, Näslund I, Lagerstedt AS, Narfström K, Olsson JM. Electrochemical treatment of tumours. Bioelectrochemistry 2000; 51:1-11. [PMID: 10790774 DOI: 10.1016/s0302-4598(99)00073-2] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The electrochemical treatment (EChT) of tumours implies that tumour tissue is treated with a continuous direct current through two or more electrodes placed in or near the tumour. The treatment offers considerable promise of a safe, simple and relatively noninvasive anti-tumour therapy for treatment of localised malignant as well as benign tumours. Although more than 10,000 patients have been treated in China during the past 10 years, EChT has not yet been universally accepted. The reason for this is the lack of essential preclinical studies and controlled clinical trials. Uncertainties regarding the destruction mechanism of EChT also hinder the development of an optimised and reliable dose-planning methodology. This article reviews the collected Chinese and occidental experiences of the electrochemical treatment of tumours, alone and in combination with other therapies. The current knowledge of the destruction mechanism underlying EChT is presented along with different approaches towards a dose planning methodology. In addition, we discuss our view of different important parameters that have to be accounted for, if clinical trials are to be initiated outside of China.
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Affiliation(s)
- E Nilsson
- Department of Chemical Engineering and Technology, Applied Electrochemistry, Royal Institute of Technology (KTH), Stockholm, Sweden.
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Jaroszeski MJ, Gilbert R, Nicolau C, Heller R. In vivo gene delivery by electroporation. Adv Drug Deliv Rev 1999; 35:131-137. [PMID: 10837694 DOI: 10.1016/s0169-409x(98)00068-4] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The physical phenomenon of electroporation has been successfully exploited in vitro for the delivery of genes, drugs, and other molecules with increasing frequency over the past two decades. This type of electrically mediated delivery has been translated into an in vivo setting in more recent years with a focus on therapeutic molecules. One promising area is the delivery of genes as a therapy.Advances in molecular medicine have produced a very large amount of information about genes that translate to therapeutic molecules when expressed in living cells. Current standard methods for transferring genes utilize viruses to deliver DNA into cells. These viral methods have not yielded optimal results in most cases. Therefore, there is an increasing interest in nonviral methods for gene delivery. In vivo electrically mediated gene delivery is an attractive alternative because of the site specific nature of delivery as well as the universal applicability of electroporation. A review of the studies performed to investigate and develop this new gene delivery technology is presented.
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Affiliation(s)
- MJ Jaroszeski
- Department of Surgery, MDC Box 16, College of Medicine, University of South Florida, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612-4799, USA
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Abstract
The combined treatment consisting of a chemotherapeutic agent and pulsed electric fields has been termed electrochemotherapy. This relatively new treatment modality relies on the physical effects of locally applied electric fields to destabilize cell membranes in the presence of a drug. Membrane destabilization, electroporation, allows increased movement of molecules into the cytosol. Thus, the pulses are used to locally deliver drugs to the interior of cells. This type of treatment has principally been used to deliver bleomycin to tumor cells in vitro and in vivo. Marked antitumor effects have been reported in preclinical studies. In addition, electrochemotherapy clinical trials have been conducted for the treatment of head and neck squamous cell carcinoma, melanoma, and basal cell carcinoma. Objective response rates ranging from 72 to 100% have been reported from these trials. A review of the preclinical and clinical data for this novel drug delivery method is presented.
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