title: Electrochemotherapy in the treatment of Kaposi sarcoma cutaneous lesions: a two-center prospective phase II trial.
abstract: BACKGROUND
  Electrochemotherapy (ECT) is an emerging treatment for cutaneous lesions of different tumor types. The combination of chemotherapy and electroporation enhances drug uptake into tumoral cells. However, its role in the treatment of Kaposi sarcoma (KS) has not yet been well defined, and to date, literature reports are scarce. We prospectively evaluated clinical activity and safety of ECT in KS patients.
  
  
  METHODS
  Twenty-three patients with histologically confirmed unresectable KS, not treatable by radiotherapy or intralesional vincristine therapy, were enrolled onto the study according to the European Standard Operating Procedures of Electrochemotherapy (ESOPE) guidelines and treated with a pulse generator.
  
  
  RESULTS
  A response to the first ECT session was obtained in all patients, with a complete response (CR) in 14 (60.9%) of 23 patients. A second ECT was performed in 5 (21.7%) and a third in 2, with a median interval between two sessions of 5.1 (range 2.5-25.5) months. Overall, a total of 15 patients (65%) experienced a CR. After a median follow-up of 1.5 years (range 2 months to 4.2 years), 16 patients maintained the response, 4 after repeated courses. Sustained local control of treated lesions was present in 20 of 23 patients. The overall survival rate was 74.4% at 2 years.
  
  
  CONCLUSIONS
  ECT represents an additional therapeutic tool for the management of KS cutaneous lesions, characterized by a definite clinical activity and long-lasting remissions. The absence of systemic side effects and the low impact on the immune system also make this treatment suitable for elderly people, even with repeated courses.
authors.affiliation: Department of Dermatology and Plastic Surgery, Dermatologic Clinic, University of Rome La Sapienza, Rome, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Curatolo
authors.forename: Pietro
authors.initials: P
authors.lastname: Quaglino
authors.forename: Federica
authors.initials: F
authors.lastname: Marenco
authors.forename: Monica
authors.initials: M
authors.lastname: Mancini
authors.forename: Tiziana
authors.initials: T
authors.lastname: Nardò
authors.forename: Claudio
authors.initials: C
authors.lastname: Mortera
authors.forename: Roberta
authors.initials: R
authors.lastname: Rotunno
authors.forename: Stefano
authors.initials: S
authors.lastname: Calvieri
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Bernengo
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D053672:Electrochemotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012514:Sarcoma, Kaposi / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents