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Editor's Choice, British Journal of Dermatology, Volume 176, Issue 6, 1 June 2017, Page i, https://doi.org/10.1111/bjd.15589
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Electrochemotherapy in the treatment of −metastatic malignant melanoma
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The authors of this multicentre European study explain that electrochemotherapy (ECT) is regarded as an effective local treatment for cutaneous metastasis. Treatment involves the administration of chemotherapeutic drugs followed by delivery of electrical pulses to the tumour. The aim of this study was to investigate the effectiveness of ECT in cutaneous metastases of melanoma and to identify factors that affect (beneficially or adversely) the outcome. ECT consisted of intratumoral or intravenous injection of bleomycin, followed by application of electric pulses under local or general anaesthesia. 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 overall response (defined as complete response + partial response). In total 394 lesions were treated, of which 306 (78%) showed overall response, with 229 showing complete response (58%). 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. The authors concluded that 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.
