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

C. Kunte, V. Letulé, J. Gehl, K. Dahlstroem, P. Curatolo, R. Rotunno, T. Muir, A. Occhini, G. Bertino, B. Powell, W. Saxinger, G. Lechner, S. H. Liew, R. Pritchard-Jones, P. Rutkowski, M. Zdzienicki, D. Mowatt, A. J. Sykes, A. Orlando, G. MitsalaC. R. Rossi, L. Campana, M. Brizio, F. de Terlizzi, P. Quaglino, J. Odili, InspECT (the International Network for Sharing Practices on Electrochemotherapy)

Research output: Contribution to journalArticle

Abstract

Background: (ECT) is an effective local treatment for cutaneous metastasis. Treatment involves the administration of chemotherapeutic drugs followed by delivery of electrical pulses to the tumour. Objectives: To investigate the effectiveness of ECT in cutaneous metastases of melanoma and to identify factors that affect (beneficially or adversely) the outcome. Methods: Thirteen cancer centres in the International Network for Sharing Practices on Electrochemotherapy consecutively and prospectively uploaded data to a common database. ECT consisted of intratumoral or intravenous injection of bleomycin, followed by application of electric pulses under local or general anaesthesia. Results: In total, 151 patients with metastatic melanoma were identified from the database, 114 of whom had follow-up data of 60 days or more. Eighty-four of these patients (74%) experienced an overall response (OR = complete response + partial response). Overall, 394 lesions were treated, of which 306 (78%) showed OR, with 229 showing complete response (58%). In multivariate analysis, factors positively associated with overall response were coverage of deep margins, absence of visceral metastases, presence of lymphoedema and treatment of nonirradiated areas. Factors significantly associated with complete response to ECT treatment were coverage of deep margins, previous irradiation of the treated area and tumour size (< 3 cm). One-year overall survival in this cohort of patients was 67% (95% confidence interval 57–77%), while melanoma-specific survival was 74% (95% confidence interval 64–84%). No serious adverse events were reported, and the treatment was in general very well tolerated. Conclusions: ECT is a highly effective local treatment for melanoma metastases in the skin, with no severe adverse effects noted in this study. In the presence of certain clinical factors, ECT may be considered for local tumour control as an alternative to established local treatments, or as an adjunct to systemic treatments.

Original languageEnglish
Pages (from-to)1475-1485
Number of pages11
JournalBritish Journal of Dermatology
Volume176
Issue number6
DOIs
Publication statusPublished - Jun 1 2017

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Electrochemotherapy
Melanoma
Cohort Studies
Prospective Studies
Neoplasm Metastasis
Therapeutics
Skin
Neoplasms
Databases
Confidence Intervals
Lymphedema
Survival
Bleomycin
Local Anesthesia
Intravenous Injections
General Anesthesia
Multivariate Analysis

ASJC Scopus subject areas

  • Dermatology

Cite this

Kunte, C., Letulé, V., Gehl, J., Dahlstroem, K., Curatolo, P., Rotunno, R., ... InspECT (the International Network for Sharing Practices on Electrochemotherapy) (2017). Electrochemotherapy in the treatment of metastatic malignant melanoma: a prospective cohort study by InspECT. British Journal of Dermatology, 176(6), 1475-1485. https://doi.org/10.1111/bjd.15340

Electrochemotherapy in the treatment of metastatic malignant melanoma : a prospective cohort study by InspECT. / Kunte, C.; Letulé, V.; Gehl, J.; Dahlstroem, K.; Curatolo, P.; Rotunno, R.; Muir, T.; Occhini, A.; Bertino, G.; Powell, B.; Saxinger, W.; Lechner, G.; Liew, S. H.; Pritchard-Jones, R.; Rutkowski, P.; Zdzienicki, M.; Mowatt, D.; Sykes, A. J.; Orlando, A.; Mitsala, G.; Rossi, C. R.; Campana, L.; Brizio, M.; de Terlizzi, F.; Quaglino, P.; Odili, J.; InspECT (the International Network for Sharing Practices on Electrochemotherapy).

In: British Journal of Dermatology, Vol. 176, No. 6, 01.06.2017, p. 1475-1485.

Research output: Contribution to journalArticle

Kunte, C, Letulé, V, Gehl, J, Dahlstroem, K, Curatolo, P, Rotunno, R, Muir, T, Occhini, A, Bertino, G, Powell, B, Saxinger, W, Lechner, G, Liew, SH, Pritchard-Jones, R, Rutkowski, P, Zdzienicki, M, Mowatt, D, Sykes, AJ, Orlando, A, Mitsala, G, Rossi, CR, Campana, L, Brizio, M, de Terlizzi, F, Quaglino, P, Odili, J & InspECT (the International Network for Sharing Practices on Electrochemotherapy) 2017, 'Electrochemotherapy in the treatment of metastatic malignant melanoma: a prospective cohort study by InspECT', British Journal of Dermatology, vol. 176, no. 6, pp. 1475-1485. https://doi.org/10.1111/bjd.15340
Kunte, C. ; Letulé, V. ; Gehl, J. ; Dahlstroem, K. ; Curatolo, P. ; Rotunno, R. ; Muir, T. ; Occhini, A. ; Bertino, G. ; Powell, B. ; Saxinger, W. ; Lechner, G. ; Liew, S. H. ; Pritchard-Jones, R. ; Rutkowski, P. ; Zdzienicki, M. ; Mowatt, D. ; Sykes, A. J. ; Orlando, A. ; Mitsala, G. ; Rossi, C. R. ; Campana, L. ; Brizio, M. ; de Terlizzi, F. ; Quaglino, P. ; Odili, J. ; InspECT (the International Network for Sharing Practices on Electrochemotherapy). / Electrochemotherapy in the treatment of metastatic malignant melanoma : a prospective cohort study by InspECT. In: British Journal of Dermatology. 2017 ; Vol. 176, No. 6. pp. 1475-1485.
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abstract = "Background: (ECT) is an effective local treatment for cutaneous metastasis. Treatment involves the administration of chemotherapeutic drugs followed by delivery of electrical pulses to the tumour. Objectives: To investigate the effectiveness of ECT in cutaneous metastases of melanoma and to identify factors that affect (beneficially or adversely) the outcome. Methods: Thirteen cancer centres in the International Network for Sharing Practices on Electrochemotherapy consecutively and prospectively uploaded data to a common database. ECT consisted of intratumoral or intravenous injection of bleomycin, followed by application of electric pulses under local or general anaesthesia. Results: In total, 151 patients with metastatic melanoma were identified from the database, 114 of whom had follow-up data of 60 days or more. Eighty-four of these patients (74{\%}) experienced an overall response (OR = complete response + partial response). Overall, 394 lesions were treated, of which 306 (78{\%}) showed OR, with 229 showing complete response (58{\%}). In multivariate analysis, factors positively associated with overall response were coverage of deep margins, absence of visceral metastases, presence of lymphoedema and treatment of nonirradiated areas. Factors significantly associated with complete response to ECT treatment were coverage of deep margins, previous irradiation of the treated area and tumour size (< 3 cm). One-year overall survival in this cohort of patients was 67{\%} (95{\%} confidence interval 57–77{\%}), while melanoma-specific survival was 74{\%} (95{\%} confidence interval 64–84{\%}). No serious adverse events were reported, and the treatment was in general very well tolerated. Conclusions: ECT is a highly effective local treatment for melanoma metastases in the skin, with no severe adverse effects noted in this study. In the presence of certain clinical factors, ECT may be considered for local tumour control as an alternative to established local treatments, or as an adjunct to systemic treatments.",
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T2 - a prospective cohort study by InspECT

AU - Kunte, C.

AU - Letulé, V.

AU - Gehl, J.

AU - Dahlstroem, K.

AU - Curatolo, P.

AU - Rotunno, R.

AU - Muir, T.

AU - Occhini, A.

AU - Bertino, G.

AU - Powell, B.

AU - Saxinger, W.

AU - Lechner, G.

AU - Liew, S. H.

AU - Pritchard-Jones, R.

AU - Rutkowski, P.

AU - Zdzienicki, M.

AU - Mowatt, D.

AU - Sykes, A. J.

AU - Orlando, A.

AU - Mitsala, G.

AU - Rossi, C. R.

AU - Campana, L.

AU - Brizio, M.

AU - de Terlizzi, F.

AU - Quaglino, P.

AU - Odili, J.

AU - InspECT (the International Network for Sharing Practices on Electrochemotherapy)

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Background: (ECT) is an effective local treatment for cutaneous metastasis. Treatment involves the administration of chemotherapeutic drugs followed by delivery of electrical pulses to the tumour. Objectives: To investigate the effectiveness of ECT in cutaneous metastases of melanoma and to identify factors that affect (beneficially or adversely) the outcome. Methods: Thirteen cancer centres in the International Network for Sharing Practices on Electrochemotherapy consecutively and prospectively uploaded data to a common database. ECT consisted of intratumoral or intravenous injection of bleomycin, followed by application of electric pulses under local or general anaesthesia. Results: In total, 151 patients with metastatic melanoma were identified from the database, 114 of whom had follow-up data of 60 days or more. Eighty-four of these patients (74%) experienced an overall response (OR = complete response + partial response). Overall, 394 lesions were treated, of which 306 (78%) showed OR, with 229 showing complete response (58%). In multivariate analysis, factors positively associated with overall response were coverage of deep margins, absence of visceral metastases, presence of lymphoedema and treatment of nonirradiated areas. Factors significantly associated with complete response to ECT treatment were coverage of deep margins, previous irradiation of the treated area and tumour size (< 3 cm). One-year overall survival in this cohort of patients was 67% (95% confidence interval 57–77%), while melanoma-specific survival was 74% (95% confidence interval 64–84%). No serious adverse events were reported, and the treatment was in general very well tolerated. Conclusions: ECT is a highly effective local treatment for melanoma metastases in the skin, with no severe adverse effects noted in this study. In the presence of certain clinical factors, ECT may be considered for local tumour control as an alternative to established local treatments, or as an adjunct to systemic treatments.

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