Electrochemotherapy: progress and prospects.

Treatment of recurrent or unresectable cutaneous and subcutaneaous tumors continues to be a major therapeutic challenge. Electrochemotherapy (ECT) is a palliative treatment of cutaneous and subcutaneous tumor nodules for which standard treatments (e.g. radiotherapy, chemotherapy, and surgery) have failed or proved to be insufficient. ECT combines the electropulsation of tumor cells (by local application of electric pulses) and the administration of antineoplastic drugs such as cisplatin or bleomycin (either intravenous or intratumoral). The permeability of the cancer cells to these poorly permeant anti-tumor drugs is transiently increased up to a hundred-fold. ECT is thus an efficient loco-regional therapy for palliative treatment of unresectable recurrent tumor nodules with overall objective response rates of approximatively 80-90% and has satisfactory cosmetic results. The next challenge for ECT is the treatment of deep-seated tumors and metastases. The joint therapy of ECT and electrotransfer of immune-stimulating genes or electro-photodynamic therapy could be a promising strategy for cancer eradication.