Electrochemotherapy for skin, subcutaneous, and mucosal tumors
GEM, led by Dr. Felipe Maglietti, is a regional leader in therapeutic electroporation and a pioneer in electrochemotherapy in Latin America. It combines clinical experience, applied research, and medical training in accordance with international standards.
Electrochemotherapy for skin, subcutaneous, and mucosal tumors
GEM, led by Dr. Felipe Maglietti, is a regional leader in therapeutic electroporation and a pioneer in electrochemotherapy in Latin America. It combines clinical experience, applied research, and medical training in accordance with international standards.
Procedural Guidelines
Electrochemotherapy combines an antineoplastic agent (bleomycin or cisplatin) with the application of a pulsed electric field that causes reversible electroporation in cell membranes.
This temporary increase in permeability allows the intracellular concentration of the drug to rise significantly and enhances local cytotoxicity.
Biomedical Fundamentals
- Cell permeabilization is a universal phenomenon, independent of histology.
- Although all exposed cells will undergo DNA cleavage, only replicating cells will undergo cell death, primarily via apoptosis.
- It allows for the treatment of wide margins without causing significant damage to healthy tissue.
- It has an excellent safety profile, with a low complication rate and proven clinical reproducibility.
- A technique standardized in accordance with the 2018 ESOPE international guidelines.
International benchmark
Updated Standard Operating Procedures for Electrochemotherapy of Cutaneous Tumors and Skin Metastases (ESOPE 2018) — DOI: 10.1080/0284186X.2018.1454602
Indications
- Skin metastases of any histological type that present with bleeding, ulceration, discharge, odor, or pain.
- Progression of skin metastases, in which the symptoms mentioned in the previous point are expected to develop.
- Primary skin cancer, including recurrent tumors where other treatments have failed or cannot be administered.
- Patients who are receiving systemic therapy but whose skin metastases do not respond satisfactorily despite showing a good response in internal organs.
- Patients who prefer electrochemotherapy over other treatment options.
*Updated Standard Operating Procedures for Electrochemotherapy of Cutaneous Tumors and Skin Metastases (ESOPE 2018) — DOI: 10.1080/0284186X.2018.1454602
It is also particularly useful for:
Head and neck tumors, including those of the eyelids, lips, ears, and palate, can be effectively treated.
It can be used to shrink a tumor prior to surgery or to widen insufficient surgical margins.
It has demonstrated synergy with immunotherapy, enhancing the systemic response to it by altering the tumor-suppressive microenvironment.
It is ideal for situations where functional or aesthetic preservation is required.
GEM Service Models
Patient Referrals (Treating Physicians)
For treating physicians who wish to refer a patient while remaining actively involved
The referring professional remains actively involved in the treatment plan.
GEM provides:
- Clinical Evaluation and Feasibility of Electrochemotherapy
- Procedure under ESOPE parameters
- Joint monitoring of developments
- Detailed technical report for the medical record
In-house implementation (Hospitals and clinics)
For institutions that wish to incorporate electrochemotherapy into their own operations
GEM offers:
- Clinical and technical training for medical teams
- Initial training and periodic refresher courses based on changes in international standards
- Installation and Setup of the Medical Electroporator
- Standardized protocols
- Clinical, scientific, and administrative support
In-house implementation (Hospitals and clinics)
For institutions that wish to incorporate electrochemotherapy into their own operations
GEM offers:
- Clinical and technical training for medical teams
- Initial training and periodic refresher courses based on changes in international standards
- Installation and Setup of the Medical Electroporator
- Standardized protocols
- Clinical, scientific, and administrative support
Coverage by private health plans, employer-sponsored health plans, and health insurance
For private health plans, employee health insurance programs, and health insurers seeking to incorporate coverage backed by clinical and legal expertise
GEM supports:
- Design of coverage criteria
- Medical-legal documentation
- Clinical case presentations
- Protocols for including the treatment among the services offered.
Equipment and supplies
OncoPore® is, to date, the only certified medical-grade electroporator available in Latin America, developed specifically for electroporation-based applications. Its design and operation are aligned with the technical requirements established by the 2018 ESOPE guidelines, ensuring reproducible procedure execution across different healthcare settings.
Technical specifications and competitive advantages:
- Valid ANMAT certification, ensuring regulatory compliance for use in medical procedures.
- High reproducibility of electrical parameters, with automated and controlled pulse delivery, reducing the margin of technical error between operators.
- Interchangeable electrodes for treating superficial, subcutaneous, and deep tumors, as well as anatomically complex areas.
- Precise distribution of the electric field, optimized to maximize cellular permeabilization without damaging healthy tissue.
- Electrical safety has been validated; suitable for use in conjunction with other medical devices.
Institutional benefits:
- It highlights the institution’s ability to provide state-of-the-art treatment that meets European standards.
- The equipment is highly reliable and comes with support and an extended warranty.
- It generates data relevant to the preparation of post-procedure reports.
- Given its features, it can be installed in operating rooms of varying levels of complexity.
Private health insurance, employer-sponsored health plans, and coverage
We work with Argentina’s leading private health insurance providers, social security plans, and health insurance companies, offering comprehensive support to ensure efficient and technically sound authorization management.
Prepaid plans with a history of coverage
Regulatory support and auditing
Electrochemotherapy is supported by scientific evidence and has a legal precedent at both the national and international levels.
The necessary documentation is provided for consideration by the medical review board, including the excellent cost-benefit profile it offers the institution.
Support during the coverage authorization process
The GEM team provides support at every stage of the process, including:
Patient presentation according to internationally accepted criteria for diagnosis.
Technical and medical documentation that complies with audit standards.
Therapeutic rationale based on scientific evidence (ESOPE 2018).
Preparation of medical-legal reports and briefs.
Authorization Management.
Legal action, as appropriate.
Learn More About Electrochemotherapy
Certificate Course from the HA Barceló Foundation
Format: online
Duration: 1 month
- 4 asynchronous theory modules
- 4 online hands-on classes
Endorsed by:
- Barceló Foundation University Institute
- International Society for Electroporation (ISEBTT)
Intended for: Dermatologists, oncologists, surgeons, geriatricians, and multidisciplinary teams.
Research and Development
GEM promotes research and development initiatives in therapeutic electroporation aimed at optimizing treatment and expanding its clinical applications. The main areas of research include:
- Gene transfer
- Integration with immunotherapy
- Advanced electrical parameters
- Development of new electrodes
- Expansion of clinical indications
This approach aims to promote clinical innovation and regional collaboration with medical institutions and research centers.
Scientific and Bibliographic Resources
Access to a selection of scientific and academic resources focused on clinical practice, research, and medical education.
Includes:
- Documentation on indications and clinical uses
- International Guidelines (ESOPE 2018)
- Principles and foundations of treatment
- Clinical Applications and Case Studies
- Evidence on combination with immunotherapy
- Audiovisual and bibliographic materials
Professional training
Audiovisual material on fundamentals, parameters, and applications.
GEM–Barceló Program (Official Certified Course)
- Online format
- Duration: 1 month
- 4 asynchronous theory modules
- 4 online hands-on classes
- Endorsed by:
- Barceló Foundation University Institute
- International Society for Electroporation (ISEBTT)
Research and Development
GEM conducts research in the following areas:
- Development of new electrodes
- Gene transfer
- Integration with immunotherapy
- Advanced electrical parameters
- Expansion of clinical indications
Recommended reading
Access to papers on electrochemotherapy, tumor electroporation, ESOPE 2018, immunotherapy, clinical results, and advanced applications.
Contact Form
Intended for hospitals, clinics, healthcare professionals, and health insurers.
Frequently Asked Questions (FAQ)
A. Frequently Asked Questions for Physicians
Primarily based on the location and extent of the lesion. It is ideal for cutaneous or subcutaneous lesions accompanied by pain, bleeding, or local progression. It is also suitable for primary tumors where surgery carries a high risk of complications or where other therapies have been tried without success. Cardiac function, comorbidities, and concomitant systemic treatments are evaluated to assess the patient’s condition; the treatment is generally very well tolerated.
Electroporation is a physical phenomenon that increases cell permeability regardless of cell type. Bleomycin is a drug with low permeability through the cell membrane; it does not enter cells that have not been exposed to an electric field to any significant extent. Consequently, the drug concentrates in the cells of the treated area rather than in the rest of the body, and for this reason, no significant systemic adverse effects are observed at the dose used for electrochemotherapy. Once inside the cell, bleomycin translocates to the nucleus and cleaves the DNA, eliminating any cell that attempts to enter mitosis.
According to ESOPE and global clinical data, the objective response rate ranges from 60% to 100%, with variations depending on histology, tumor size, and the patient’s immune status. Basal cell and squamous cell carcinomas typically have response rates of around 80% to 90%. Other tumors, such as sarcomas or melanomas, may show a lower response rate, depending on the patient’s overall condition.
The choice of anesthesia depends on the size, location, and depth of the lesion. In most cases, electrochemotherapy is performed under neuroleptanalgesia, similar to that used for a colonoscopy. If the location or extent of the lesion requires a deeper level of anesthesia, the procedure can be performed under general anesthesia. Conversely, for small lesions and cooperative patients, it can be performed under local or regional anesthesia. The anesthesiologist determines the appropriate anesthetic approach for each patient.
Yes, electrochemotherapy is performed in the operating room.
However, it is an outpatient procedure: the patient goes home within two hours of treatment and does not require hospitalization.
The patient may experience mild, temporary pain, redness, swelling, and superficial scabbing following treatment.
Serious side effects are rare, and the surrounding healthy tissue is not affected, so recovery is usually very good.
Patients with pacemakers can undergo the treatment, provided that caution is exercised when treating lesions located on or very close to the device pocket.
In patients receiving anticoagulants or antiplatelet agents, it is recommended that medication be discontinued approximately three days before the procedure to minimize the risk of bleeding.
Immunosuppressed patients can be treated; although response rates may be lower or require more sessions, repeating the treatment improves the response and helps train the innate immune response.
Yes. Electrochemotherapy can be used as a neoadjuvant, adjuvant, or concurrent treatment.
It exhibits synergy with immunotherapy, as it reduces the local tumor burden, enhances antigen presentation, and alters the tumor-suppressive microenvironment.
Repeated sessions can stimulate both adaptive and innate immune responses, improving the immune response even in immunosuppressed patients.
B. Frequently Asked Questions for Hospitals, Clinics, Private Health Insurance Providers, and Public Health Insurance Programs
An operating room, a stable power supply, and trained staff. The GEM team assists with the setup.
It is performed as a low-complexity outpatient procedure, without hospitalization. It fits into the regular surgical schedule.
The treating professional must be trained in the technique and in basic operating room procedures (both of which are covered in the electrochemotherapy course) and must have an anesthesiologist on staff.
GEM provides support throughout the entire process: clinical presentations, reports, medical-legal arguments, and appeals when necessary.
No. Electrochemotherapy is a highly cost-effective procedure; it will help you reduce costs for complex patients and give you a competitive edge over other centers that do not offer this therapy.
