Electrochemotherapy as a new therapeutic strategy in advanced Merkel cell carcinoma of head and neck region

Abstract

BackgroundMerkel Cell Carcinoma (MCC) is a rare and aggressive tumour, arising from a cutaneous mechanoceptor cell located in the basal layer of epidermis, with poor prognosis. The treatment of choice for the initial stage of the disease is surgery and/or radiotherapy. The treatment of recurrent or advanced disease is still controversial.Case reportWe report a case of 84 years old woman with a recurrent MCC of the chin treated with electrochemotherapy (ECT). During the period of 20 months, four sessions of ECT were employed, which resulted in an objective response of the tumour and good quality of residual life.ConclusionsOur case shows the effectiveness of ECT in the treatment of locally advanced MCC of the head and neck region in a patient not suitable for standard therapeutic options.

Application of electrochemotherapy in the management of primary and metastatic cutaneous malignant tumours: a systematic review and meta-analysis

“…Efficacy of electrochemotherapy has been reported to be independent of the treated tumour types [14,15,42,49,82,92]. Similarly, in the current review, electrochemotherapy was found to be effective for basal cell carcinoma [2,21,50,78,93], malignant melanoma [2,5,12,13,17,21,23,36,40,73,74,79,92,[94][95][96][97], cutaneous lesions of breast cancer [2,63,64,80], squamous cell carcinoma [2,21,96,[98][99][100], Kaposi's sarcoma [55][56][57], Merkel cell carcinoma [41,60,61,96,101], and other tumours. The efficacy of this method is presented in more detail in table 2.…”

“…It can therefore be used at lower doses than those needed for classic chemotherapies [7,13,31]. In previous studies, electrochemotherapy with bleomycin was found to be effective for primary and metastatic malignant melanoma [2,5,17,20,30,[36][37][38][39][40][41][42][43][44][45][46][47][48][49], primary and metastatic basal cell carcinoma [2,21,38,44,[50][51][52], primary and metastatic squamous cell carcinoma [44,47,49,53], Kaposi's sarcoma [41,43,49,[54][55][56][57][58][59], Merkel cell carcinoma [41,60,61], cutaneous primary and metastatic lesions of breast cancer [49,[62][63]…”

Diagnosis and treatment of Merkel Cell Carcinoma. European consensus-based interdisciplinary guideline

“…Electrochemotherapy is a relatively new treatment modality which can find indication in locally advanced lesions [34].…”

Electrochemotherapy of superficial tumors – Current status:

“…Positive treatment results with BCC [11,118,122,[192][193][194][195][196][197][198][199][200] and SCC [122,172,187,[201][202][203] have been reported in several case series ( Table 7 ), while clinical experience in Merkel cell carcinoma [204][205][206] , sebaceous carcinoma [207] , and keratoacanthoma is still patchy [11,92,118,122,123,127,177,196,197,208,209] . ECT can be advantageous in patients with multifocal BCC (eg, in Gorlin-Goltz syndrome or Xeroderma Pigmentosum) to reduce the morbidity associated with repetitive surgical excisions [109,197] , and several creditable reports are available [109,47,192,193,199,210] .…”