Louise Wichmann Matthiessen1, Mohammed Keshtgar2, Pietro Curatolo3, Christian Kunte4, Eva-Maria Grischke5, Joy Odili6, Tobian Muir7, David Mowatt8, James P Clover9, Se Hwang Liew10, Karin Dahlstroem11, Jackie Newby12, Valerie Letulé13, Eva Stauss5, Alison Humphreys14, Shramana Banerjee15, Annette Klein16, Roberta Rotunno3, Francesca de Terlizzi17, Julie Gehl18. 1. Department of Oncology, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark. Electronic address: louise.wichmann.matthiessen@regionh.dk. 2. Department of Breast Surgery, Royal Free London NHS Foundation Trust, London, United Kingdom. 3. Department of Internal Medicine and Medical Specialties, Division of Dermatology, University of Rome "La Sapienza", Rome, Italy. 4. Department of Dermatologic Surgery and Dermatology, Artemed Fachklinik München, Munich, Germany; Department of Dermatology and Allergology, Ludwig-Maximilian University Munich, Munich, Germany. 5. Department of Gynecology, University Hospital of Tübingen, Tübingen, Germany. 6. Department of Plastic Surgery, St George's University Hospitals NHS Foundation Trust, London, United Kingdom. 7. Department of Reconstructive Plastic Surgery, James Cook University Hospital, Middlesbrough, United Kingdom. 8. Department of Plastic Surgery, The Christie Hospital, Manchester, United Kingdom. 9. Department of Plastic Surgery, Cork University Hospital and Cork Cancer Research Centre, University College Cork, Cork, Ireland. 10. Merseyside Regional Burns and Plastic Surgery Unit, Whiston Hospital, Liverpool, United Kingdom. 11. Department of Plastic Surgery, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark. 12. Department of Medical Oncology, Royal Free London NHS Foundation Trust, London, United Kingdom. 13. Department of Dermatology and Allergology, Ludwig-Maximilian University Munich, Munich, Germany. 14. Department of Oncology, James Cook University Hospital, Middlesbrough, United Kingdom. 15. Department of Breast Surgery, Royal Free London NHS Foundation Trust, London, United Kingdom; Division of Surgery and Interventional Science, University College London, London, United Kingdom. 16. Department of Dermatologic Surgery and Dermatology, Artemed Fachklinik München, Munich, Germany. 17. IGEA Spa, Carpi, Italy. 18. Department of Oncology, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark; Center for Experimental Drug and Gene Electrotransfer (C*EDGE), Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Abstract
BACKGROUND: Cutaneous recurrence from breast cancer can pose a clinical challenge. It might be the only disease site, or could be part of disseminated disease, and often profoundly affects quality of life. Electrochemotherapy is a palliative treatment using electric pulses to locally permeabilize tumor cells and thereby significantly increase bleomycin cytotoxicity. Collaborating with the International Network for Sharing Practice on ElectroChemoTherapy (INSPECT), we consecutively and prospectively accrued data on patients treated with electrochemotherapy for cutaneous metastases from breast cancer. PATIENTS AND METHODS: Patients were treated with electrochemotherapy at 10 European centers. Under either local or general anaesthesia patients were treated with either local injection (1000 IU/mL intratumoral) or systemic infusion (15,000 IU/m2) of bleomycin. RESULTS: One hundred nineteen patients were included at 10 institutions in the INSPECT network. The primary location was the chest (89%), the median diameter of the cutaneous metastases was 25 mm. Ninety patients were available for response evaluation after 2 months. Complete response was observed in 45 patients (50%), partial response in 19 (21%), stable disease in 16 (18%), and progressive disease in 7 (8%). Three patients were not evaluable. Common side effects were ulceration, long-lasting hyperpigmentation, and low-grade pain. No serious adverse events were observed. CONCLUSION: Electrochemotherapy showed high response rates after a single treatment. Electrochemotherapy has few side effects and can be used as an adjunct to systemic therapies or as a solo treatment. We therefore recommend considering electrochemotherapy for patients with cutaneous metastases.
BACKGROUND: Cutaneous recurrence from breast cancer can pose a clinical challenge. It might be the only disease site, or could be part of disseminated disease, and often profoundly affects quality of life. Electrochemotherapy is a palliative treatment using electric pulses to locally permeabilize tumor cells and thereby significantly increase bleomycincytotoxicity. Collaborating with the International Network for Sharing Practice on ElectroChemoTherapy (INSPECT), we consecutively and prospectively accrued data on patients treated with electrochemotherapy for cutaneous metastases from breast cancer. PATIENTS AND METHODS: Patients were treated with electrochemotherapy at 10 European centers. Under either local or general anaesthesia patients were treated with either local injection (1000 IU/mL intratumoral) or systemic infusion (15,000 IU/m2) of bleomycin. RESULTS: One hundred nineteen patients were included at 10 institutions in the INSPECT network. The primary location was the chest (89%), the median diameter of the cutaneous metastases was 25 mm. Ninety patients were available for response evaluation after 2 months. Complete response was observed in 45 patients (50%), partial response in 19 (21%), stable disease in 16 (18%), and progressive disease in 7 (8%). Three patients were not evaluable. Common side effects were ulceration, long-lasting hyperpigmentation, and low-grade pain. No serious adverse events were observed. CONCLUSION: Electrochemotherapy showed high response rates after a single treatment. Electrochemotherapy has few side effects and can be used as an adjunct to systemic therapies or as a solo treatment. We therefore recommend considering electrochemotherapy for patients with cutaneous metastases.
Authors: Giulia Bertino; Ales Groselj; Luca G Campana; Christian Kunte; Hadrian Schepler; Julie Gehl; Tobian Muir; James A P Clover; Pietro Quaglino; Erika Kis; Matteo Mascherini; Brian Bisase; Giancarlo Pecorari; Falk Bechara; Paolo Matteucci; Joy Odili; Francesco Russano; Antonio Orlando; Rowan Pritchard-Jones; Graeme Moir; David Mowatt; Barbara Silvestri; Veronica Seccia; Werner Saxinger; Francesca de Terlizzi; Gregor Sersa Journal: Front Oncol Date: 2022-09-20 Impact factor: 5.738