Electrochemotherapy in the treatment of metastatic malignant melanoma: a prospective cohort study by InspECT

Kunte, Christian; Letulé, Valerie; Gehl, Julie; Dahlstroem, Karin; Curatolo, P.; Rotunno, Roberta; Muir, Tobian; Occhini, Antonio; Bertino, Giulia; Powell, Barry; Saxinger, Werner; Lechner, G; Liew, Se Hwang; Pritchard-Jones, Rowan; Rutkowski, Piotr; Zdzienicki, Marcin; Mowatt, David; Sykes, Andrew J; Orlando, Antonio; Mitsala, Grammatiki; Rossi, Carlo Riccardo; Campana, Luca Giovanni; Brizio, Matteo; Terlizzi, Francesca de; Quaglino, Pietro; Odili, Joy

doi:10.1111/bjd.15340

Cited by 95 publications

(115 citation statements)

References 46 publications

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“…Interestingly, these figures are in line with a recently published study by the InspECT group. In this experience, Kunte et al 16 investigated 151 patients with melanoma (with 394 tumours) who underwent ECT with standard BLM dosages and reported an ORR of 77% (complete, 58%). Interestingly, the patients included in the study of Kunte et al and in our study were comparable for the main predictors of response (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…In the subgroup of melanoma patients (n = 22), we observed a 78% ORR (complete, 55%). We compared the tumour response in these 22 patients with the outcome of the patients with melanoma inscribed in the InspECT registry (n = 114) and recently published by Kunte et al 16 The two groups were comparable as for patient age (P = 0.428), tumour size (P = 0.284), presence of visceral metastases (P = 0.710) and previous radiotherapy (P = 0.073). The ORR in these two cohorts was 78% and 77%, respectively (P = 1.000), while the CR rate was 55% in both groups (P = 1.000).…”

Section: Tumour Responsementioning

confidence: 99%

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Electrochemotherapy of unresectable cutaneous tumours with reduced dosages of intravenous bleomycin: analysis of 57 patients from the International Network for Sharing Practices of Electrochemotherapy registry

Rotunno

Campana

Quaglino

et al. 2017

Acad Dermatol Venereol

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Section: Discussionmentioning

confidence: 99%

Section: Tumour Responsementioning

confidence: 99%

Electrochemotherapy of unresectable cutaneous tumours with reduced dosages of intravenous bleomycin: analysis of 57 patients from the International Network for Sharing Practices of Electrochemotherapy registry

Rotunno

Campana

Quaglino

et al. 2017

Acad Dermatol Venereol

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“…In this analysis, melanoma comprised 83.3% of all cutaneous metastases (8). We already know multiple factors influencing treatment efficacy: coverage of deep margins, absence of visceral metastases, presence of lymphoedema, treatment of non-irradiated areas and tumour size <3 cm (9). These parameters help clinicians to decide whether a patient is more suitable for ECT alone or combined with other therapeutic strategies.…”

Section: Electrochemotherapymentioning

confidence: 99%

Electrochemotherapy for the treatment of melanoma skin metastases in the era of new drugs

Brizio¹

2017

cderm

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SummaryThe incidence of melanoma has been increasing for more than 40 years and in the clinical course of this neoplasia cutaneous metastases are not unusual. Electrochemotherapy (ECT) is an already well recognised therapeutic tool for the local treatment of cutaneous and subcutaneous metastases of melanoma showing sustained anti-tumour activity and favourable toxicity profile. Treatment involves the local or intravenous administration of chemo therapeutic drugs followed by delivery of electrical pulses to the tumour. Recent advances in systemic therapies have dramatically modified melanoma therapeutic approach on stage III and IV with increased survival rates. However, the cutaneous metastases management still represents a challenge for clinicians due to pain, bleeding, odour and psychosocial distress related to the lesions but also for the limited efficacy on the skin offered by newly available systemic strategies. ECT may be considered for local tumour control as an alternative to established local treatments but it could be also favourably associated to immune and target therapies to improve their efficacy. Recent findings suggest indeed that electrochemotherapy may exert a role in boosting anti-tumour immunity and to avoid skin metastases resistance to systemic treatments.KEY WORDS: electrochemotherapy; melanoma skin metastases; immunotherapy; target therapy. IntroductionThe incidence of melanoma has been increasing for more than 40 years in western countries, although the incidence rate for all cancer sites combined is decreasing. Since 1975, age-standardized melanoma incidence in the United States nearly tripled to 22.9 per 100,000 persons in 2012 and also in Italy in the last 10 years melanoma diagnosis are almost doubled. Talking about prognosis, the 10-year survival rate for patients with an early-stage melanoma is greater than 95% but prognosis is much more severe for patients diagnosed with advanced disease: an overall 1-year survival of 25.5% and a median survival of 6.2 months were achieved, without any significant improvement during the last 30 years (1). Melanoma accounts for about 18% of the total cases of cutaneous metastases (2) even if their management is often challenging. In fact, patients with cutaneous disease may suffer from pain, bleeding, and malodour determining a reduced quality of life. Since 2006, electrochemotherapy (ECT) has been introduced as a standardized procedure in the field of dermato-oncology as a treatment option for cutaneous and subcutaneous lesions, including melanoma. ElectrochemotherapyThe first human trial conducted on 1991 demonstrated the efficacy and safety of electrochemotherapy in the treatment of cutaneous and subcutaneous metastases from different primary tumours. Then the field has rapidly developed since the procedure has been recognized as an effective and safe local treatment for cutaneous, subcutaneous and mucosal lesions (3,4). A European project published in 2006 (ESOPE) established standardized operating procedures (5). The treatment can be administe...

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“…), metastatic cutaneous melanoma (Kunte et al. ), liver metastases of carcinomas (Edhemovic et al. ), sarcomas (Marty et al.…”

Section: Introductionmentioning

confidence: 99%

Conjunctival melanoma and electrochemotherapy: preliminary results using 2D and 3D cell culture models in vitro

Fiorentzis

Katopodis

Kalirai

et al. 2018

Acta Ophthalmologica

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Purpose To investigate the cytotoxic effect of bleomycin, mitomycin C ( MMC ) and Fluorouracil (5‐ FU ) in combination with electroporation ( EP ) on human conjunctival melanoma ( CM ) and normal conjunctival cell lines using 2D and 3D cell culture systems in vitro . Methods Two CM ( CRMM 1, CRMM 2) and one normal conjunctival epithelial cell line ( HC jE‐Gi) were treated with various EP conditions and increasing concentrations of 5‐ FU , MMC and bleomycin. Cell survival was assessed by MTT viability assay. All cell lines were seeded to create spheroids and were treated with bleomycin on day 3 and day 8 combined with EP . Spheroids were collected, fixed in buffered formalin and subsequently paraffin embedded for histological assessment of the effects of the treatment on cell viability. Results CM cell lines were resistant to electroporation alone and showed a reduction in cell number only when treated with 1000 Volts/cm and 8 pulses. HC jE‐Gi cells showed higher sensitivity to electric pulses over 750 Volts/cm. MMC and 5‐ FU demonstrated a higher cytotoxicity for the HC jE‐Gi cell line. The CM cell lines were resistant to MMC and 5‐ FU . Bleomycin (1 μ g/ml) alone had no significant effect on the HC jE‐Gi even when combined with EP conditions ≥750 Volts/cm. In contrast, it significantly (p ‐, paired t‐test) reduced cell viability in the CM cell lines. Spheroids treated with bleomycin and EP showed a reduction in tumour mass and proliferation rates after treatment. Conclusion Our in vitro study using 2D and 3D models indicates that the application of EP may effectively enhance chemotherapy with bleomycin in CM . This may offer new viable perspectives for CM treatment.

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Electrochemotherapy in the treatment of metastatic malignant melanoma: a prospective cohort study by InspECT

Cited by 95 publications

References 46 publications

Electrochemotherapy of unresectable cutaneous tumours with reduced dosages of intravenous bleomycin: analysis of 57 patients from the International Network for Sharing Practices of Electrochemotherapy registry

Electrochemotherapy of unresectable cutaneous tumours with reduced dosages of intravenous bleomycin: analysis of 57 patients from the International Network for Sharing Practices of Electrochemotherapy registry

Electrochemotherapy for the treatment of melanoma skin metastases in the era of new drugs

Conjunctival melanoma and electrochemotherapy: preliminary results using 2D and 3D cell culture models in vitro

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