Clinical Evidence & Guidelines

The ESOPE study1 was a landmark study published in 2006. The ESOPE protocol for ElectroChemoTherapy (ECT) is based on this study, and it is the only protocol recommended for treatment with the SENNEX® system.

ECT is now recognized as a treatment alternative in several treatment guidelines. Since 2013, it is recommended for treatment of cutaneous metastases and melanoma in the National Institute for Health and Care Excellence (NICE) guidelines: The guidelines state: “There is sufficient evidence of efficacy of ECT for treating metastases in the skin from tumours of non-skin origin and melanoma to support its use as a palliative treatment. There are no major safety concerns. Therefore, in the context of palliative treatment the procedure can be used with normal arrangements for clinical governance, consent and audit.” 

ECT is also recognized as palliative treatment alternative in head and neck cancer for cutaneous metastases and tumors recurring after multimodality treatment.3

Furthermore, ECT is recommended as an alternative for treatment of in-transit melanomas in the Swedish National Guidelines for Melanoma4 and in the treatment of malignant wounds.5


  1. European Standard Operating Procedures for Electrochemotherapy (ESOPE) Studies:  Mir, LM; Gehl, J; Sersa, G; Collins, CG; Garbay, J-R; Billard, Vet al.:“Standard operating procedures of the ECT” in European Journal of Cancer Supplements, 2006(4): 14-25
  2. NICE, UK 2013 –
  3. National Guidelines for Head & Neck Cancer, Sweden –
  4. National Guidelines for Malignant Melanomas, Sweden
  5. National Guidelines for Malignant Wounds, Sweden –—gotland/malignatumorsar2015-05-26_uppdatering2015-07-28.pdf


The Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) has released an enquiry response about electrochemotherapy. The SBU is one of the oldest health technology assessment organisations in the world.


The report is available in Swedish here.


A translated version is available here.