TY - JOUR
T1 - Electrochemotherapy of skin metastases from breast cancer
T2 - a systematic review
AU - Ferioli, Martina
AU - Perrone, Anna Myriam
AU - Buwenge, Milly
AU - Arcelli, Alessandra
AU - Zamagni, Alice
AU - Macchia, Gabriella
AU - Deodato, Francesco
AU - Cilla, Savino
AU - Tagliaferri, Luca
AU - De Terlizzi, Francesca
AU - De Iaco, Pierandrea
AU - Zamagni, Claudio
AU - Morganti, Alessio Giuseppe
N1 - Publisher Copyright:
© 2020, Springer Nature B.V.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/2
Y1 - 2021/2
N2 - Skin metastases occur in 5–30% of breast cancer (BC) patients. Standard treatments include systemic therapies (chemotherapy, endocrine therapy, and immunotherapy) and local treatments (surgery and radiotherapy). Electrochemotherapy (ECT) could be another option in this setting based on preclinical and clinical studies. Aim of this review was to analyze the available evidence on ECT in skin metastases from BC. Studies reporting on ECT in skin metastases from BC were included in this review. Studies not reporting toxicity or tumor response or not reporting results separately from other primary cancers were excluded. The search was based on Medline, Scopus, and The Cochrane Library databases. Eleven studies including 464 patients were analyzed. ECT was performed using intravenous/intratumoral bleomycin (10 studies) or intratumoral cisplatin (one study). Complete and overall pooled response rates were 46.2% (95%CI 33.2–59.4 and 74.6% (95%CI 60.6–86.4) in studies reporting results on a per patient basis and 61.9% (95%CI 53.8–69.6) and 86.9% (95%CI 80.0–92.6) in studies reporting results on a per lesion basis, respectively. Worse response rates in larger lesions were observed in three studies. The incidence of toxicity was heterogeneous but adverse events were mild and manageable in all studies. One- and 3-year local progression-free survival was 86.2% and 81.0% in two studies, respectively. ECT is tolerable and effective in terms of response in BC skin metastases especially in less advanced lesions. Further studies are justified to compare ECT with other treatments in this setting.
AB - Skin metastases occur in 5–30% of breast cancer (BC) patients. Standard treatments include systemic therapies (chemotherapy, endocrine therapy, and immunotherapy) and local treatments (surgery and radiotherapy). Electrochemotherapy (ECT) could be another option in this setting based on preclinical and clinical studies. Aim of this review was to analyze the available evidence on ECT in skin metastases from BC. Studies reporting on ECT in skin metastases from BC were included in this review. Studies not reporting toxicity or tumor response or not reporting results separately from other primary cancers were excluded. The search was based on Medline, Scopus, and The Cochrane Library databases. Eleven studies including 464 patients were analyzed. ECT was performed using intravenous/intratumoral bleomycin (10 studies) or intratumoral cisplatin (one study). Complete and overall pooled response rates were 46.2% (95%CI 33.2–59.4 and 74.6% (95%CI 60.6–86.4) in studies reporting results on a per patient basis and 61.9% (95%CI 53.8–69.6) and 86.9% (95%CI 80.0–92.6) in studies reporting results on a per lesion basis, respectively. Worse response rates in larger lesions were observed in three studies. The incidence of toxicity was heterogeneous but adverse events were mild and manageable in all studies. One- and 3-year local progression-free survival was 86.2% and 81.0% in two studies, respectively. ECT is tolerable and effective in terms of response in BC skin metastases especially in less advanced lesions. Further studies are justified to compare ECT with other treatments in this setting.
KW - Breast cancer
KW - Electrochemotherapy
KW - Local control
KW - Skin metastases
KW - Systematic review
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U2 - 10.1007/s10585-020-10063-x
DO - 10.1007/s10585-020-10063-x
M3 - Review article
C2 - 33180222
AN - SCOPUS:85095982078
VL - 38
JO - Clinical and Experimental Metastasis
JF - Clinical and Experimental Metastasis
SN - 0262-0898
IS - 1
ER -