Immune checkpoint blockade with concurrent electrochemotherapy in advanced melanoma: a retrospective multicenter analysis.
Growing evidence suggests that concurrent loco-regional and systemic treatment modalities may lead to synergistic anti-tumor effects in advanced melanoma. In this retrospective multicenter study, we evaluate the use of electrochemotherapy (ECT) combined with ipilimumab or PD-1 inhibition. We investigated patients with unresectable or metastatic melanoma who received the combination of ECT and immune checkpoint blockade for distant or cutaneous metastases within 4 weeks. Clinical and laboratory data were collected and analyzed with respect to safety and efficacy. A total of 33 patients from 13 centers were identified with a median follow-up time of 9 months. Twenty-eight patients received ipilimumab, while five patients were treated with a PD-1 inhibitor (pembrolizumab n = 3, nivolumab n = 2). The local overall response rate (ORR) was 66.7 %. The systemic ORR was 19.2 and 40.0 % in the ipilimumab and PD-1 cohort, respectively. The median duration of response was not reached in either group. The median time to disease progression was 2.5 months for the entire population with 2 months for ipilimumab and 5 months for PD-1 blockade. The median overall survival was not reached in patients with ipilimumab and 15 months in the PD-1 group. Severe systemic adverse events were detected in 25.0 % in the ipilimumab group. No treatment-related deaths were observed. This is the first reported evaluation of ECT and simultaneous PD-1 inhibition and the largest published dataset on ECT with concurrent ipilimumab. The local response was lower than reported for ECT only. Ipilimumab combined with ECT was feasible, tolerable and showed a high systemic response rate.
Department of Dermatology and Allergy, Munich University Hospital (LMU), Frauenlobstr. 9-11, 80337, Munich, Germany.
Markus V
MV
Heppt
Department of Dermatology, Center for Dermatooncology, University Hospital Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Germany.
Thomas K
TK
Eigentler
Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 7, 24105, Kiel, Germany.
Katharina C
KC
Kähler
HELIOS Skin Cancer Center Erfurt, HELIOS Clinic Erfurt, Nordhäuser Str. 74, 99089, Erfurt, Germany.
Rudolf A
RA
Herbst
Department of Dermatology and Venereology, Otto-von-Guericke-University Hospital, Leipziger Str. 44, 39120, Magdeburg, Germany.
Daniela
D
Göppner
Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, Gudrunstr. 56, 44791, Bochum, Germany.
Thilo
T
Gambichler
Department of Dermatology, Harzklinikum Dorothea Christiane Erxleben, Ditfurter Weg 24, 06484, Quedlinburg, Germany.
Jens
J
Ulrich
Department of Dermatology, Clinical Center Ludwigshafen, Bremserstr. 79, 67073, Ludwigshafen, Germany.
Edgar
E
Dippel
Department of Dermatology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
Carmen
C
Loquai
Department of Dermatology, SRH Wald-Klinikum Gera GmbH, Str. des Friedens 122, 07548, Gera, Germany.
Beatrice
B
Schell
Department of Dermatology, University Hospital, University Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany.|German Cancer Consortium (DKTK), Heidelberg, Germany.
Bastian
B
Schilling
Department of Dermatology and Venereology, University Medical Center Rostock, Strempelstr.13, 18057, Rostock, Germany.
Susanne G
SG
Schäd
Department of Dermatology, General Hospital Nuremberg, Paracelsus Medical University, Prof.-Ernst-Nathan-Str. 1, 90419, Nuremberg, Germany.
Erwin S
ES
Schultz
Department of Dermatology and Allergy, Munich University Hospital (LMU), Frauenlobstr. 9-11, 80337, Munich, Germany.
Fanny
F
Matheis
Department of Dermatology and Allergy, Munich University Hospital (LMU), Frauenlobstr. 9-11, 80337, Munich, Germany.
Julia K
JK
Tietze
Department of Dermatology and Allergy, Munich University Hospital (LMU), Frauenlobstr. 9-11, 80337, Munich, Germany. Carola.Berking@med.uni-muenchen.de.
Carola
C
Berking
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059447:Cell Cycle Checkpoints / Q000276:immunology*; D053672:Electrochemotherapy / Q000379:methods*; D006801:Humans; D008545:Melanoma / Q000276:immunology* / Q000473:pathology; D008875:Middle Aged; D012189:Retrospective Studies
Electrochemotherapy; Immune checkpoint blockade; Ipilimumab; Melanoma; Nivolumab; Pembrolizumab