Endoscopic electrochemotherapy for esophageal cancer: a phase I clinical study

Charlotte Egeland; Lene Baeksgaard; Helle Hjorth Johannesen; Johan Löfgren; Christina Caroline Plaschke; Lars Bo Svendsen; Julie Gehl; Michael Patrick Achiam

doi:10.1055/a-0590-4053

Endoscopy International Open, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(06): E727-E734
DOI: 10.1055/a-0590-4053

Original article

Endoscopic electrochemotherapy for esophageal cancer: a phase I clinical study

Charlotte Egeland

¹Department of Surgical Gastroenterology, Rigshospitalet, University of Copenhagen, Denmark

,

Lene Baeksgaard

²Department of Oncology, Rigshospitalet, University of Copenhagen, Denmark

,

Helle Hjorth Johannesen

³Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Denmark

,

Johan Löfgren

³Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Denmark

,

Christina Caroline Plaschke

⁴Department of Otorhinolaryngology, Head and Neck Surgery & Audiology, Rigshospitalet, University of Copenhagen, Denmark

,

Lars Bo Svendsen

¹Department of Surgical Gastroenterology, Rigshospitalet, University of Copenhagen, Denmark

,

Julie Gehl

⁵Center for Experimental Drug and Gene Electrotransfer (C*EDGE), Department of Clinical Oncology and Palliative Care, Herlev University Hospital, Copenhagen, Denmark

⁶Department of Clinical Medicine, Faculty of Health and Medical Sciences, Zealand University Hospital, University of Copenhagen, Denmark

,

Michael Patrick Achiam

¹Department of Surgical Gastroenterology, Rigshospitalet, University of Copenhagen, Denmark

› Institutsangaben

Abstract

Background and study aims Esophageal cancer is on the rise in the western world and the disease has a poor 5-year survival prognosis below 20 %. Electrochemotherapy is a treatment where a chemotherapeutic drug is combined with locally applied electrical pulses, in order to increase the drug’s cytotoxicity in malignant cells. This study presents the first results with electrochemotherapy treatment in esophageal cancer.

Patients and methods In this first-in-human trial, six patients with advanced esophageal cancer were treated with electrochemotherapy using intravenous bleomycin. All side effects and adverse events (AEs) were registered and the patients were later evaluated with gastroscopy and 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI).

Results Treatment were well tolerated, main AEs being nausea, vomiting, oral thrush, pneumonia, retrosternal pain, fever, and hoarseness. No serious complications were observed. Five patients had a visual tumor response confirmed by gastroscopy. In two cases, these findings were confirmed with 18F-FDG PET/MRI as it revealed a reduction of total tumor mass.

Conclusion Electrochemotherapy in patients with advanced esophageal cancer was conducted without major safety concerns. This study paves the way for larger studies, which may further elucidate response rates for and side effects of this new treatment.

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