CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(06): E727-E734
DOI: 10.1055/a-0590-4053
Original article
Owner and Copyright © Georg Thieme Verlag KG 2018

Endoscopic electrochemotherapy for esophageal cancer: a phase I clinical study

Charlotte Egeland
Department of Surgical Gastroenterology, Rigshospitalet, University of Copenhagen, Denmark
,
Lene Baeksgaard
Department of Oncology, Rigshospitalet, University of Copenhagen, Denmark
,
Helle Hjorth Johannesen
Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Denmark
,
Johan Löfgren
Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Denmark
,
Christina Caroline Plaschke
Department of Otorhinolaryngology, Head and Neck Surgery & Audiology, Rigshospitalet, University of Copenhagen, Denmark
,
Lars Bo Svendsen
Department of Surgical Gastroenterology, Rigshospitalet, University of Copenhagen, Denmark
,
Julie Gehl
Center for Experimental Drug and Gene Electrotransfer (C*EDGE), Department of Clinical Oncology and Palliative Care, Herlev University Hospital, Copenhagen, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, Zealand University Hospital, University of Copenhagen, Denmark
,
Michael Patrick Achiam
Department of Surgical Gastroenterology, Rigshospitalet, University of Copenhagen, Denmark
› Author Affiliations
Further Information

Publication History

submitted 29 January 2018

accepted after revision 08 February 2018

Publication Date:
25 May 2018 (online)

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.