Metastatic Basal Cell Carcinoma With Squamous Differentiation

Abstract

Background: Metastatic basal cell carcinoma is a rare disease with poor prognosis. Palliative therapeutic approaches include surgery, radiotherapy, and/or chemotherapy. These treatment modalities are invasive and risky and associated with relevant adverse effects. Electrochemotherapy is a recently described therapy that relies on the permeation of cancer cell membranes by electrical pulses to enhance cytotoxic drug penetration. It has been successfully used in the treatment of primary and metastatic skin cancers. We report a case of metastatic basal cell carcinoma in which electrochemotherapy was effective in inducing local regression of skin metastases.

The Evidence of the Bystander Effect after Bleomycin Electrotransfer and Irreversible Electroporation

“…Similarly, the indirect effects after bleomycin electrotransfer as well as irreversible electroporation can also be associated with the bystander effect. It is important to note that bleomycin electrotransfer is closely associated with antitumor electrochemotherapy (ECT), an anticancer treatment modality that is currently implemented in clinics over the world as a local anticancer treatment therapy [ 38 , 39 ]. A well-known process of bleomycin-induced ROS generation in the presence of metal ions, like Cu + or Fe 2+ , and oxygen, results in cellular DNA degradation [ 40 , 41 ].…”

Basal cell carcinoma: 10-year experience with electrochemotherapy

“…It is remarkable that no comparative trials have been carried out so far and no cost-analyses are available. The bulk of the literature consists of small observational series, often including heterogeneous skin cancers [10, 12, 14–18, 24]. In an early trial, Glass et al [16] reported a 98% response rate after one or more ECT cycles with intralesional bleomycin and no recurrences detected after 18 months.…”

“…According to the European standard operative procedure of ECT (ESOPE), bleomycin can be administered either intratumorally or intravenously, according to the disease burden, while cisplatin can be injected intratumorally, in patients with few and small tumors [7]. Since the publication of the ESOPE in 2006, an increasing number of studies have provided evidence of ECT efficacy on different tumor histotypes [8–12]. On this basis, the National Institute for Health and Care Excellence (NICE) has recently recognized ECT as a safe alternative option for BCC patients (NICE interventional procedure guidance [IPG478], published date: February 2014).…”

“…However, since the evidence basis is limited and established treatments provides high cure rates, clinicians involved in ECT are encouraged to systematically collect data on case selection, treatment parameters, patient outcomes and, possibly, to submit these data to the International Network for Sharing practices on Electrochemotherapy (InspECT) register (website: http://www.insp-ect.org/) [13]. Although BCC is by far the most frequent skin cancer, clinical experience with ECT is still scarce [10–12, 14–18], probably due to the availability of several established treatment options [19]. In the present study, we sought to examine the feasibility, efficacy and toxicity of ECT in BCC and to gain insights into this potential field of ECT application.…”

Electrochemotherapy in the Treatment of Bone Metastases: A Phase II Trial

“…The multicenter study ESOPE (European Standard Operating Procedure for ECT) demonstrated that ECT may achieve an objective response rate of 85 % (74 % complete response rate) in treated tumour lesions [5,6]. Furthermore, in nodules undergoing complete response, long-term histology shows that no residual tumour cells are detected locally [7][8][9].…”