Study protocol designed to investigate tumour response to calcium electroporation in cancers affecting the skin: a non-randomised phase II clinical trial

Mille Vissing, John Pløen, Mascha Pervan, Kitt Vestergaard, Mazen Schnefeldt, Stine Krog Frandsen, Søren Rafael Rafaelsen, Christina Louise Lindhardt, Lars Henrik Jensen, Rody Achim, Julie Gehl*

*Corresponding author for this work

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Abstract

Introduction Skin malignancy is a distressing problem for many patients, and clinical management is challenging. This article describes the protocol for the Calcium Electroporation Response Study (CaEP-R) designed to investigate tumour response to calcium electroporation and is a descriptive guide to calcium electroporation treatment of malignant tumours in the skin. Calcium electroporation is a local treatment that induces supraphysiological intracellular calcium levels by intratumoural calcium administration and application of electrical pulses. The pulses create transient membrane pores allowing diffusion of non-permeant calcium ions into target cells. High calcium levels can kill cancer cells, while normal cells can restore homeostasis. Prior trials with smaller cohorts have found calcium electroporation to be safe and efficient. This trial aims to include a larger multiregional cohort of patients with different cancer diagnoses and also to investigate treatment areas using MRI as well as assess impact on quality of life. Methods and analysis This non-randomised phase II multicentre study will investigate response to calcium electroporation in 30 patients with cutaneous or subcutaneous malignancy. Enrolment of 10 patients is planned at three centres: Zealand University Hospital, University Hospital of Southern Denmark and University Hospital Schleswig-Holstein. Response after 2 months was chosen as the primary endpoint based on short-term response rates observed in a prior clinical study. Secondary endpoints include response to treatment using MRI and change in quality of life assessed by questionnaires and qualitative interviews. Ethics and dissemination The trial is approved by the Danish Medicines Agency and The Danish Regional Committee on Health Research Ethics. All included patients will receive active treatment (calcium electroporation). Patients can continue systemic treatment during the study, and side effects are expected to be limited. Data will be published in a peer-reviewed journal and made available to the public. Trial registration numbers NCT04225767 and EudraCT no: 2019-004314-34.

Original languageEnglish
Article numbere046779
JournalB M J Open
Volume11
Issue number6
Number of pages10
ISSN2044-6055
DOIs
Publication statusPublished - 16. Jun 2021

Keywords

  • MRI
  • calcium
  • cancer
  • electroporation
  • metastases
  • qualitative interviews
  • skin
  • tumour response
  • Calcium, Dietary
  • Calcium
  • Humans
  • Electroporation
  • Multicenter Studies as Topic
  • Quality of Life
  • Clinical Trials, Phase II as Topic
  • Skin Neoplasms/drug therapy

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