Abstract
Electrochemotherapy (ECT) represents an attractive locoregional therapy for unresectable chest wall recurrence (≥WR) from breast cancer. Thirty-five patients with cutaneous CWR after mastectomy who experienced progression despite re-irradiation and extensive systemic treatments were administered bleomycin-based ECT. Local response, toxicity, and superficial control were evaluated. Out of 516 metastases (median 15/patient, range 1-50), response was assessed on 196 target lesions (median size 20 mm, range 10-220). Patients received a median of 2 ECT courses (range 1-3). Two-month objective response was as follows: 54.3 % complete (19/35 patients), 37.1 % partial (13/35), and 8.6 % no change (3/35). Twenty-three patients (65.7 %) developed new lesions (NL) after a median time of 6.6 months (range 2.3-29.5), therefore 1, 2, or 3 ECT cycles were required in 14, 15, and 6 patients, respectively. Median follow-up was 32 months (range 6-53) and the 3-year local control rate was 81 %. Related morbidity was mild, increased after retreatments and consisted primarily of pain (reported as "moderate"/"severe" by 6, 13, and 17 % of patients 1 month after the first, second, and third application, respectively) and dermatological toxicity (acute G3 skin ulceration in 14, 20, and 33 % ofpatients, respectively). Less than 10 metastases (P <0.001), the narrower area of tumor spread on the chest wall (P = 0.022), complete response achievement (P = 0.019), and post-ECT endocrine instead of chemotherapy (P = 0.025) were associated to NL-free survival. Only fewer skin metastases, hazard ratio (HR) 0.122, 95 % confidence interval (≥I) 0.037-0.397, P <0.001, and contained superficial spread, HR 0.234, 95 % CI 0.067-0.818, P = 0.023, were predictors for longer NL-free survival. ECT showed a satisfactory activity in refractory breast cancer CWR, providing sustained local control. Patients with fewer and less scattered skin metastases are less likely todevelop NL. Partial respondersand NL can be handled with additional ECT albeit increasing local pain and skin toxicity.
| Original language | English |
|---|---|
| Pages (from-to) | 1169-1178 |
| Number of pages | 10 |
| Journal | Breast Cancer Research and Treatment |
| Volume | 134 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Aug 2012 |
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Keywords
- Advanced cancer chest wall recurrence
- Bleomycin
- Breast cancer
- Electrochemotherapy
- Electroporation
ASJC Scopus subject areas
- Oncology
- Cancer Research
Cite this
The activity and safety of electrochemotherapy in persistent chest wall recurrence from breast cancer after mastectomy : A phase-II study. / Campana, Luca G.; Valpione, Sara; Falci, Cristina; Mocellin, Simone; Basso, Michela; Corti, Luigi; Balestrieri, Nicola; Marchet, Alberto; Rossi, Carlo R.
In: Breast Cancer Research and Treatment, Vol. 134, No. 3, 08.2012, p. 1169-1178.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The activity and safety of electrochemotherapy in persistent chest wall recurrence from breast cancer after mastectomy
T2 - A phase-II study
AU - Campana, Luca G.
AU - Valpione, Sara
AU - Falci, Cristina
AU - Mocellin, Simone
AU - Basso, Michela
AU - Corti, Luigi
AU - Balestrieri, Nicola
AU - Marchet, Alberto
AU - Rossi, Carlo R.
PY - 2012/8
Y1 - 2012/8
N2 - Electrochemotherapy (ECT) represents an attractive locoregional therapy for unresectable chest wall recurrence (≥WR) from breast cancer. Thirty-five patients with cutaneous CWR after mastectomy who experienced progression despite re-irradiation and extensive systemic treatments were administered bleomycin-based ECT. Local response, toxicity, and superficial control were evaluated. Out of 516 metastases (median 15/patient, range 1-50), response was assessed on 196 target lesions (median size 20 mm, range 10-220). Patients received a median of 2 ECT courses (range 1-3). Two-month objective response was as follows: 54.3 % complete (19/35 patients), 37.1 % partial (13/35), and 8.6 % no change (3/35). Twenty-three patients (65.7 %) developed new lesions (NL) after a median time of 6.6 months (range 2.3-29.5), therefore 1, 2, or 3 ECT cycles were required in 14, 15, and 6 patients, respectively. Median follow-up was 32 months (range 6-53) and the 3-year local control rate was 81 %. Related morbidity was mild, increased after retreatments and consisted primarily of pain (reported as "moderate"/"severe" by 6, 13, and 17 % of patients 1 month after the first, second, and third application, respectively) and dermatological toxicity (acute G3 skin ulceration in 14, 20, and 33 % ofpatients, respectively). Less than 10 metastases (P <0.001), the narrower area of tumor spread on the chest wall (P = 0.022), complete response achievement (P = 0.019), and post-ECT endocrine instead of chemotherapy (P = 0.025) were associated to NL-free survival. Only fewer skin metastases, hazard ratio (HR) 0.122, 95 % confidence interval (≥I) 0.037-0.397, P <0.001, and contained superficial spread, HR 0.234, 95 % CI 0.067-0.818, P = 0.023, were predictors for longer NL-free survival. ECT showed a satisfactory activity in refractory breast cancer CWR, providing sustained local control. Patients with fewer and less scattered skin metastases are less likely todevelop NL. Partial respondersand NL can be handled with additional ECT albeit increasing local pain and skin toxicity.
AB - Electrochemotherapy (ECT) represents an attractive locoregional therapy for unresectable chest wall recurrence (≥WR) from breast cancer. Thirty-five patients with cutaneous CWR after mastectomy who experienced progression despite re-irradiation and extensive systemic treatments were administered bleomycin-based ECT. Local response, toxicity, and superficial control were evaluated. Out of 516 metastases (median 15/patient, range 1-50), response was assessed on 196 target lesions (median size 20 mm, range 10-220). Patients received a median of 2 ECT courses (range 1-3). Two-month objective response was as follows: 54.3 % complete (19/35 patients), 37.1 % partial (13/35), and 8.6 % no change (3/35). Twenty-three patients (65.7 %) developed new lesions (NL) after a median time of 6.6 months (range 2.3-29.5), therefore 1, 2, or 3 ECT cycles were required in 14, 15, and 6 patients, respectively. Median follow-up was 32 months (range 6-53) and the 3-year local control rate was 81 %. Related morbidity was mild, increased after retreatments and consisted primarily of pain (reported as "moderate"/"severe" by 6, 13, and 17 % of patients 1 month after the first, second, and third application, respectively) and dermatological toxicity (acute G3 skin ulceration in 14, 20, and 33 % ofpatients, respectively). Less than 10 metastases (P <0.001), the narrower area of tumor spread on the chest wall (P = 0.022), complete response achievement (P = 0.019), and post-ECT endocrine instead of chemotherapy (P = 0.025) were associated to NL-free survival. Only fewer skin metastases, hazard ratio (HR) 0.122, 95 % confidence interval (≥I) 0.037-0.397, P <0.001, and contained superficial spread, HR 0.234, 95 % CI 0.067-0.818, P = 0.023, were predictors for longer NL-free survival. ECT showed a satisfactory activity in refractory breast cancer CWR, providing sustained local control. Patients with fewer and less scattered skin metastases are less likely todevelop NL. Partial respondersand NL can be handled with additional ECT albeit increasing local pain and skin toxicity.
KW - Advanced cancer chest wall recurrence
KW - Bleomycin
KW - Breast cancer
KW - Electrochemotherapy
KW - Electroporation
UR - http://www.scopus.com/inward/record.url?scp=84868207419&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84868207419&partnerID=8YFLogxK
U2 - 10.1007/s10549-012-2095-4
DO - 10.1007/s10549-012-2095-4
M3 - Article
C2 - 22821399
AN - SCOPUS:84868207419
VL - 134
SP - 1169
EP - 1178
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
SN - 0167-6806
IS - 3
ER -