Long-lasting response to electrochemotherapy in melanoma patients with cutaneous metastasis

Abstract

BackgroundTreatment of early and multiple cutaneous unresectable recurrences is a major therapeutic problem with around 80% of patients relapsing within 5 years. For lesions refractory to elective treatments, electrochemotherapy (ECT) involving electroporation combined with antineoplastic drug treatment appears to be a new potential option. This study was undertaken to analyze the short- and long-term responses of lesions treated with ECT with intravenous injection of bleomycin in melanoma patients with in-transit disease or distant cutaneous metastases.MethodsBetween June 2007 and September 2012, 60 patients with relapsed and refractory cutaneous melanoma metastases or in-transit disease underwent 100 courses of ECT with intravenous injection of bleomycin. Response to treatment was evaluated three months after ECT. A long-lasting response was defined as no cutaneous or in-transit relapse after a minimum of six months.ResultsThree months after ECT, a complete response was observed in 29 patients (48.4%), a partial response in 23 patients (38.3%) and no change or progressive disease in 8 patients (13.3%). The objective response rate of all treated lesions was 86.6%. Thirteen patients (44.8% of complete responders) experienced a long-lasting response after one ECT session and were disease-free after a mean duration of follow-up of 27.5 months.ConclusionsThe favorable outcome obtained in the present study demonstrates that ECT is a reliable, and effective procedure that provides long-term benefit in terms of curative and palliative treatment for unresectable cutaneous lesions without adversely impacting the quality of life of patients.

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

“…Caracò et al . reported that 45% of complete responders experienced a long‐lasting response after one ECT session and were disease free after a mean follow‐up of 27·5 months . In our study, as well as in former published studies, the clinical activity of ECT was accompanied with a favourable toxicity profile with no severe side‐effects.…”

“…Several studies have investigated the effectiveness of ECT . A study on the efficacy and safety of ECT published in 2006 by Mir et al .…”

Electrochemotherapy

“…Therefore, the patient underwent conservative surgery, which allowed sparing the oral mucosa and the floor of the orbit, while the reconstruction was easily obtained by means of a rotation flap. At 1-year followup, the patient was disease-free, with good functional and esthetic results, as confirmed by CT and FDG PET/CT (29). This is a single patient case report, whose results should be confirmed by other studies.…”

“…In 2008, Curatolo et al reported ECT of a local recurrence of penile Kaposi sarcoma (KS), with a CR and no signs of local relapse 14 months after completion of the treatment (30). These data suggest that ECT could be a valid alternative to surgery, especially in difficult anatomical sites.…”

How Imaging Molecule Uptake into Cells can Reveal the Mechanisms of Membrane Electropermeabilization

“…Electrochemotherapy is a standard treatment in many cancer centers around Europe that potentiates the delivery of cytotoxic drugs by local electric pulses delivery (http://guidance. nice.org.uk/IPG446) (5). This strategy is also promising for the systemic secretion of therapeutic proteins.…”