Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 8/2008

01-08-2008 | Melanomas

Electrochemotherapy with Intravenous Bleomycin in the Local Treatment of Skin Melanoma Metastases

Authors: P. Quaglino, MD, C. Mortera, MD, S. Osella-Abate, PhD, M. Barberis, MD, M. Illengo, MD, M. Rissone, MD, P. Savoia, MD, M. G. Bernengo, MD

Published in: Annals of Surgical Oncology | Issue 8/2008

Login to get access

Abstract

Background

Electrochemotherapy (ECT) combines chemotherapy and electroporation to increase drug uptake. Its role in cutaneous melanoma metastasis treatment is not well defined; indeed, few studies have been reported, without complete follow-up data.

Aim

To prospectively evaluate clinical activity and tolerability of ECT with i.v. bleomycin, and to analyze the response increase associated to repeated sessions, in the largest series of cutaneous melanoma metastases reported to date (n = 233).

Patients and Methods

14 stage III relapsed/refractory patients were enrolled according to European Standard Operating Procedures of Electrochemotherapy (ESOPE) guidelines and treated under general sedation using the CliniporatorTM pulse generator.

Results

A response was obtained in 13/14 patients (93%) after the first ECT, with a complete regression (CR) in 7 (50%). Seven patients underwent a second and three a third ECT on newly appearing and residual lesions, all achieving a response. Overall, a response was obtained in 93% metastases, with lower response rates in >1 cm2 lesions. The CR rate was 58%; none of the CR nodules relapsed. The repeated ECT sessions gave rise to a new response in 21/29 (72%) re-treated lesions. The local tumor control rate was 74.5% at 2 years.

Conclusion

ECT is a safe procedure, easily performed in terms of toxicities and cost-effectiveness ratios, and constitutes a therapeutic tool for relapsed/refractory cutaneous melanoma patients. The repeated ECT sessions are associated with a response increase in re-treated lesions which could allow to overcome the reduced activity in >1 cm2 sized metastases.
Literature
1.
Meier F, Will S, Ellwanger U, et al. Metastatic pathways and time courses in the orderly progression of cutaneous melanoma. Br J Dermatol 2002;147:62–70PubMedCrossRef
2.
Grunhagen DJ, de Wilt JH, van Geel AN, et al. Isolated limb perfusion for melanoma patients–a review of its indications and the role of tumour necrosis factor-alpha. Eur J Surg Oncol 2006;32:371–80PubMedCrossRef
3.
Garbe C, Eigentler TK. Diagnosis and treatment of cutaneous melanoma: state of the art 2006. Melanoma Res 2007;17:117–27PubMedCrossRef
4.
Gehl J, Geertsen PF. Efficient palliation of haemorrhaging malignant melanoma skin metastases by electrochemotherapy. Melanoma Res 2000;10:585–9PubMedCrossRef
5.
Rols MP, Bachaud JM, Giraud P, et al. Electrochemotherapy of cutaneous metastases in malignant melanoma. Melanoma Res 2000;10:468–74PubMedCrossRef
6.
Gothelf A, Mir LM, Gehl J. Electrochemotherapy: results of cancer treatment using enhanced delivery of bleomycin by electroporation. Cancer Treat Rev 2003;29:371–87PubMedCrossRef
7.
Byrne CM, Thompson JF, Johnston H, et al. Treatment of metastatic melanoma using electroporation therapy with bleomycin (electrochemotherapy). Melanoma Res 2005;15:45–51PubMedCrossRef
8.
Marty M, Sersa G, Garbay JR, et al. Electrochemotherapy–An easy, highly effective and safe treatment of cutaneous and subcutaneous metastases: results of ESOPE (European Standard Operating Procedures of Electrochemotherapy) study. Eur J Cancer 2006; 4(Suppl):3–13
9.
Mir LM, Gehl J, Sersa G, et al. Standard operating procedures of the electrochemotherapy: instructions for the use of bleomycin or cisplatin administered either systemically or locally and electric pulses delivered by the CliniporatorTM by means of invasive or non-invasive electrodes. Eur J Cancer 2006; 4(Suppl):14–25
10.
Snoj M, Rudolf Z, Paulin-Kosir SM, et al. Long lasting complete response in melanoma treated by electrochemotherapy. Eur J Cancer 2006; 4(Suppl):26–8
11.
Sersa G, Miklavcic D, Cemazar M, et al. Electrochemotherapy in treatment of tumours. Eur J Surg Oncol 2008;34:232–40PubMed
12.
Zimmerman U. Electric field-mediated fusion and related electrical phenomena. Biochim Biophys Acta 1982;694:227–77
13.
Okino M, Mohri H. Effects of a high voltage electric impulse and anticancer drug on “in vivo” growing tumors. Jpn J Cancer Res 1987;78:1319–21PubMed
14.
Mir LM, Banoun H, Paoletti C. Introduction of definite amounts of nonpermeant molecules into living cells after electropermeabilization: direct access to the cytosol. Exp Cell Res 1988;175:15–25PubMedCrossRef
15.
Orlowski S, Belehradek J, Paoletti C, et al. Transient electropermeabilization of cells in culture. Increase of the cytotoxicity of anticancer drugs. Biochem Pharmacol 1988;37:4727–33PubMedCrossRef
16.
Belehradek J Jr, Orlowski S, Poddevin B, et al. Electrochemotherapy of spontaneous mammary tumours in mice. Eur J Cancer 1991;27:73–6PubMedCrossRef
17.
Mir LM, Orlowski S, Belehradek J Jr, et al. Electrochemotherapy potentiation of antitumor effect of bleomycin by local electric pulses. Eur J Cancer 1991;27:68–72PubMed
18.
Poddevin B, Orlowski S, Belehradek J Jr, et al. Very high cytotoxicity of bleomycin introduced into the cytosol of cells in culture. Biochem Pharmacol 1991;42(Suppl):67–75CrossRef
19.
Pron G, Belehradek J Jr, Mir LM. Identification of a plasma membrane protein that specifically binds bleomycin. Biochem Biophys Res Commun 1993;194:333–7PubMedCrossRef
20.
Glass LF, Pepine ML, Fenske NA, et al. Bleomycin-mediated electrochemotherapy of metastatic melanoma. Arch Dermatol 1996;132:1353–7PubMedCrossRef
21.
Heller R, Jaroszeski MJ, Reintgen DS, et al. Treatment of cutaneous and subcutaneous tumors with electrochemotherapy using intralesional bleomycin. Cancer 1998; 83:148–57PubMedCrossRef
22.
Gaudy C, Richard MA, Folchetti G, et al. Randomized controlled study of electrochemotherapy in the local treatment of skin metastases of melanoma. J Cutan Med Surg 2006;10:115–21PubMed
23.
WHO. Handbook for Reporting Results of Cancer Treatment, vol. 48. Geneva; 1997. pp 22–7
24.
Larkin JO, Collins CG, Aarons S, et al. Electrochemotherapy: aspects of preclinical development and early clinical experience. Ann Surg 2007; 245:469–79PubMedCrossRef
25.
Noorda EM, van Kreij RH, Vrouenraets BC, et al. The health-related quality of life of long-term survivors of melanoma treated with isolated limb perfusion. Eur J Surg Oncol 2007;33:776–82PubMed
26.
Sanki A, Kam PC, Thompson JF. Long-term results of hyperthermic, isolated limb perfusion for melanoma: a reflection of tumor biology. Ann Surg 2007;245:591–6PubMedCrossRef
27.
Thompson JF, Kam PC. Current status of isolated limb infusion with mild hyperthermia for melanoma. Int J Hyperthermia 2008;24:219–25PubMedCrossRef
Metadata
Title
Electrochemotherapy with Intravenous Bleomycin in the Local Treatment of Skin Melanoma Metastases
Authors
P. Quaglino, MD
C. Mortera, MD
S. Osella-Abate, PhD
M. Barberis, MD
M. Illengo, MD
M. Rissone, MD
P. Savoia, MD
M. G. Bernengo, MD
Publication date
01-08-2008
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 8/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-008-9976-0

Other articles of this Issue 8/2008

Annals of Surgical Oncology 8/2008 Go to the issue

Laboratory Research

Effects of Combined Administration of DPD-Inhibitory Oral Fluoropyrimidine, S-1, Plus Paclitaxel on Gene Expressions of Fluoropyrimidine Metabolism-Related Enzymes in Human Gastric Xenografts

Gastrointestinal Oncology

Clinical Significance of Intraoperative Bile Duct Margin Assessment for Hilar Cholangiocarcinoma

Laboratory Research

Detection and Functional Analysis of Tumor Infiltrating T-Lymphocytes (TIL) in Liver Metastases from Colorectal Cancer

Gastrointestinal Oncology

Lactate Dehydrogenase-5 (LDH-5) Expression in Human Gastric Cancer: Association with Hypoxia-Inducible Factor (HIF-1α) Pathway, Angiogenic Factors Production and Poor Prognosis

Breast Oncology

Breast Lymphatic Anatomy and Implications for Sentinel Lymph Node Biopsy

Breast Oncology

In Reply–The Lymphatic Anatomy of the Breast and its Implications for Sentinel Lymph Node Biopsy: A Human Cadaver Study