title: Long-lasting response to electrochemotherapy in melanoma patients with cutaneous metastasis.
abstract: BACKGROUND
  Treatment of early and multiple cutaneous unresectable recurrences is a major therapeutic problem with around 80% of patients relapsing within 5 years. For lesions refractory to elective treatments, electrochemotherapy (ECT) involving electroporation combined with antineoplastic drug treatment appears to be a new potential option. This study was undertaken to analyze the short- and long-term responses of lesions treated with ECT with intravenous injection of bleomycin in melanoma patients with in-transit disease or distant cutaneous metastases.
  
  
  METHODS
  Between June 2007 and September 2012, 60 patients with relapsed and refractory cutaneous melanoma metastases or in-transit disease underwent 100 courses of ECT with intravenous injection of bleomycin. Response to treatment was evaluated three months after ECT. A long-lasting response was defined as no cutaneous or in-transit relapse after a minimum of six months.
  
  
  RESULTS
  Three months after ECT, a complete response was observed in 29 patients (48.4%), a partial response in 23 patients (38.3%) and no change or progressive disease in 8 patients (13.3%). The objective response rate of all treated lesions was 86.6%. Thirteen patients (44.8% of complete responders) experienced a long-lasting response after one ECT session and were disease-free after a mean duration of follow-up of 27.5 months.
  
  
  CONCLUSIONS
  The favorable outcome obtained in the present study demonstrates that ECT is a reliable, and effective procedure that provides long-term benefit in terms of curative and palliative treatment for unresectable cutaneous lesions without adversely impacting the quality of life of patients.
authors.affiliation: Unit of Surgery "Melanoma - Soft Tissues - Head & Neck - Skin Cancers", Istituto Nazionale per lo Studio e la cura dei tumori "Fondazione G,Pascale" IRCCS, Naples, Italy. dott.marone@virgilio.it.
authors.forename: Corrado
authors.initials: C
authors.lastname: Caracò
authors.forename: Nicola
authors.initials: N
authors.lastname: Mozzillo
authors.forename: Ugo
authors.initials: U
authors.lastname: Marone
authors.forename: Ester
authors.initials: E
authors.lastname: Simeone
authors.forename: Lucia
authors.initials: L
authors.lastname: Benedetto
authors.forename: Gianluca
authors.initials: G
authors.lastname: Di Monta
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Di Cecilia
authors.forename: Gerardo
authors.initials: G
authors.lastname: Botti
authors.forename: Paolo Antonio
authors.initials: PA
authors.lastname: Ascierto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D001761:Bleomycin / Q000008:administration & dosage*; D018572:Disease-Free Survival; D053672:Electrochemotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000556:secondary; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D001761:Bleomycin