Electrochemotherapy in Melanoma Patients: A Single Institution Experience

Caracò, Corrado; Marone, Ugo; Simeone, Ester; Grimaldi, Antonio; Botti, Gerardo; Giudice, M; Ascierto, Paolo A.; Mozzillo, Nicola

doi:10.2217/mmt.15.9

Cited by 9 publications

(18 citation statements)

References 40 publications

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“…Six of them were excluded from the final analysis for the following reasons: one letter to editor, one case report, one with no data on tumor response, one without separated data on ECT, one reporting on the same patients population of a more recent study by the same authors, and one reporting on primary MM. Seven studies had a retrospective design [16][17][18][19][20][21][22], ten were prospective [11,12,[23][24][25][26][27][28][29][30] and one was a retrospective-prospective analysis [31]. Six studies were published before ESOPE guidelines were issued in 2006 [16-18, 23, 24, 26].…”

Section: Resultsmentioning

confidence: 99%

“…Most lesions were in the trunk and extremities. The size of the treated metastases was reported heterogeneously: some authors reported the volume [11,16,23,24], others the diameter [12,18,19,21,[25][26][27][28][29][30], while four papers did not describe this data [17,20,22,31]. Looking at the diameter, the range was 2-260 mm.…”

Section: Patients and Tumors Characteristicsmentioning

confidence: 99%

“…The timing of response evaluation after ECT was heterogeneous among studies but most assessments were performed four weeks after the first ECT course [11,12,16,20,21,23,24,26,31]. The Response Evaluation Criteria in Solid Tumors (RECIST) scale and the World Health Organization (WHO) criteria were used in five [12,22,[29][30][31] and 11 [11,16,[19][20][21][23][24][25][26][27][28] papers, respectively, while two studies did not report the tumor response scoring system [17,18]. Actuarial LC was reported in four studies [11,12,27,30].…”

Section: Local Controlmentioning

confidence: 99%

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Electrochemotherapy of skin metastases from malignant melanoma: a PRISMA-compliant systematic review

Ferioli

Lancellotta

Perrone³

et al. 2022

Clin Exp Metastasis

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The main treatment of MM metastases are systemic therapies, surgery, limb perfusion, and intralesional talimogene laherparepvec. Electrochemotherapy (ECT) is potentially useful also due to the high response rates recorded in cancers of any histology. No randomized studies comparing ECT with other local therapies have been published on this topic. We analyzed the available evidence on efficacy and toxicity of ECT in this setting. PubMed, Scopus, and Cochrane databases were screened for paper about ECT on MM skin metastases. Data about tumor response, mainly in terms of overall response rate (ORR), toxicity (both for ECT alone and in combination with systemic treatments), local control (LC), and overall survival (OS) were collected. The methodological quality was assessed using a 20-item validated quality appraisal tool for case series. Overall, 18 studies were included in our analysis. In studies reporting “per patient” tumor response the pooled complete response (CR) was 35.7% (95%CI 26.0–46.0%), and the pooled ORR was 80.6% (95%CI 68.7–90.1%). Regarding “per lesion” response, the pooled CR was 53.5% (95%CI 42.1–64.7%) and the pooled ORR was 77.0% (95%CI 56.0–92.6%). One-year LC rate was 80%, and 1-year OS was 67–86.2%. Pain (24.2–92.0%) and erythema (16.6–42.0%) were the most frequent toxicities. Two studies reported 29.2% and 41.6% incidence of necrosis. ECT is effective in terms of tumor response and tolerated in patients with skin metastases from MM, albeit with a wide variability of reported results. Therefore, prospective trials in this setting are warranted.

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Section: Resultsmentioning

confidence: 99%

Section: Patients and Tumors Characteristicsmentioning

confidence: 99%

Section: Local Controlmentioning

confidence: 99%

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Electrochemotherapy of skin metastases from malignant melanoma: a PRISMA-compliant systematic review

Ferioli

Lancellotta

Perrone³

et al. 2022

Clin Exp Metastasis

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“…Local treatments include surgical resection, electro-chemotherapy (ECT), ablative, topical and intralesional therapies. [11][12][13] Regional treatment options include regional radiation therapy 14 and locoregional chemotherapy by hyperthermic isolated limb perfusion (HILP) or isolated limb infusion (ILI) for locoregional melanoma metastases located in the limbs, 1 or hypoxic pelvic and limb perfusion (HPLP) for cases of synchronous inferior limb and inguinal region and/or pelvic involvement. 15 Systemic treatments, currently proposed for locoregional metastases judged to be unresectable for technical or clinical reasons, include single or combinations of agents with local and/or regional treatments.…”

Section: Introductionmentioning

confidence: 99%

A Prospective Study of Intraarterial Infusion Chemotherapy in Advanced Wild-Type BRAF Melanoma Patients

Guadagni

Zoras²,

Fiorentini³

et al. 2021

Journal of Surgical Research

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Results: The objective response rate following first cycle of locoregional chemotherapy was 37.1% at 3 mo and median progression-free survival was 4-mo, with 12.9% procedure-related complications, 30.6% low-grade haematological toxicity and 11.3% severe limb toxic tissue reactions. Multivariate logistic regression showed that the odds of response were significantly higher for patients ≤ 75 y of age and for patients with locoregional metastases exclusively located in the inferior limbs. Conclusion:In this subgroup of CM patients with BRAF wild-type status, locoregional metastases localized to inferior limbs and pelvis, in progression following or ineligible for immunotherapy, melphalan locoregional chemotherapy demonstrated a safe and effective profile.

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“…For patients with stage III and IV CM with pelvic locoregional metastases, specialist melanoma centres provide local, regional, and systemic treatment options. Local treatments include surgical resection [4], topical therapy with diphencyprone or imiquimod [5], diathermy-fulguration, cryotherapy, laser ablation, radiofrequency ablation, intralesional injection with Rose Bengal [6] or Talimogene laherparepvec [7] or Darumon or Guadagni et al BMC Res Notes (2020) 13:176 Coxsackie Virus A-21, and electro-chemotherapy [8,9]. Regional treatment options include regional radiation therapy [10,11] and hypoxic pelvic perfusion (HPP), as isolated limb perfusion and isolated limb infusion are not anatomically practical for metastases targeting.…”

Section: Introductionmentioning

confidence: 99%

Circulating tumour cell liquid biopsy in selecting therapy for recurrent cutaneous melanoma with locoregional pelvic metastases: a pilot study

et al. 2020

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Objectives: Circulating tumour cells (CTCs) from liquid biopsies provide an exceptional opportunity to obtain realtime tumour information and are under current investigation in several cancers, including cutaneous melanoma, but face significant drawbacks in terms of non-standardised methodology, low viable cell numbers and accuracy of CTC identification. In this pilot study, we report that chemosensitivity assays using liquid biopsy-derived metastatic melanoma (MM) CTCs, from 7 patients with stage IIIC, BRAF wild-type metastatic melanomas, localized exclusively to the pelvic region, un-eligible for immunotherapy and treated with melphalan hypoxic pelvic perfusion (HPP), is both feasible and useful in predicting response to therapy. Viable MM CTCs (> 5 cells/ml for all 7 blood samples), enriched by transient culture, were characterised in flow cytometry-based Annexin V-PE assays for chemosensitivity to several drugs. Results:Using melphalan as a standard, chemosensitivity cut-off values of > 60% cell death, were predictive of patient RECIST 1.1 response to melphalan HPP therapy, associated with calculated 100% sensitivity, 66.67% specificity, 33.33% positive predictive, 100% negative predictive, and 71.43% accuracy values. We propose that the methodology in this study is both feasible and has potential value in predicting response to therapy, setting the stage for a larger study.

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Electrochemotherapy in Melanoma Patients: A Single Institution Experience

Abstract: The favorable outcome obtained in the present study demonstrates that ECT is a reliable, easy, fast and effective procedure showing benefits in terms of curative and palliative treatment for unresectable cutaneous lesions respecting the quality of life.

Cited by 9 publications

References 40 publications

Electrochemotherapy of skin metastases from malignant melanoma: a PRISMA-compliant systematic review

Electrochemotherapy of skin metastases from malignant melanoma: a PRISMA-compliant systematic review

A Prospective Study of Intraarterial Infusion Chemotherapy in Advanced Wild-Type BRAF Melanoma Patients

Circulating tumour cell liquid biopsy in selecting therapy for recurrent cutaneous melanoma with locoregional pelvic metastases: a pilot study

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