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

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Kunte, C., Letulé, V., Gehl, J., Dahlstroem, K., Curatolo, P., Rotunno, R., ... Electrochemotherapy), ICT. . I. N. F. S. P. O. (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.; Electrochemotherapy), InspECT (the International Network for Sharing Practices on.

In: British Journal of Dermatology, Vol. 176, No. 6, 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, S-H, 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 & Electrochemotherapy), ICTINFSPO 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. ; Electrochemotherapy), InspECT (the International Network for Sharing Practices on. / 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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title = "Electrochemotherapy in the treatment of metastatic malignant melanoma: a prospective cohort study by InspECT",
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. {\circledC} 2017 British Association of Dermatologists",
author = "C. Kunte and V. Letul{\'e} and J. Gehl and K. Dahlstroem and P. Curatolo and R. Rotunno and T. Muir and A. Occhini and G. Bertino and B. Powell and W. Saxinger and G. Lechner and S.-H. Liew and R. Pritchard-Jones and P. Rutkowski and M. Zdzienicki and D. Mowatt and A.J. Sykes and A. Orlando and G. Mitsala and C.R. Rossi and L. Campana and M. Brizio and {de Terlizzi}, F. and P. Quaglino and J. Odili and Electrochemotherapy), {InspECT (the International Network for Sharing Practices on}",
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TY - JOUR

T1 - Electrochemotherapy in the treatment of metastatic malignant melanoma: 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 - Electrochemotherapy), InspECT (the International Network for Sharing Practices on

N1 - Cited By :7 Export Date: 22 February 2018 CODEN: BJDEA Correspondence Address: Kunte, C.; Department of Dermatology and Allergology, Ludwig-Maximilian UniversityGermany; email: christian.kunte@med.uni-muenchen.de

PY - 2017/6

Y1 - 2017/6

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. © 2017 British Association of Dermatologists

AB - 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. © 2017 British Association of Dermatologists

U2 - 10.1111/bjd.15340

DO - 10.1111/bjd.15340

M3 - Article

VL - 176

SP - 1475

EP - 1485

JO - British Journal of Dermatology

JF - British Journal of Dermatology

SN - 0007-0963

IS - 6

ER -