Electrochemotherapy offers long-term benefits in melanoma

This study examined the use of electrochemotherapy in patients with skin (cutaneous) metastases from melanoma.

Melanoma recurs (comes back) in 80% of patients within 5 years, often at sites distant to the original tumor. Melanoma cells can be spread through both the bloodstream and the lymphatic system, and it often recurs in areas which make resection (surgical removal) difficult. Melanomas also do not respond well to other types of treatment, such as chemotherapy. Therefore, new treatment directions are needed. Electrochemotherapy is a combination of a chemotherapy agent, such as bleomycin, and treatment with electric currents. The pulses of electric current make cancer cells more permeable to chemotherapy (it is easier for the chemotherapy agent to pass into the cell), thus making the chemotherapy more effective. Previous studies involving this method have shown control of tumor growth in 88% of patients, compared to 73% in patients receiving bleomycin alone. However, it is not clear how long-lasting this control is, or whether there is a similar effect on melanomas which have already metastasized (spread) or are currently spreading to other areas. This study explored the short- and long-term outcomes of electrochemotherapy in cutaneous (on the upper layer of skin) metastatic melanoma patients.

In this study, 60 patients underwent one to five courses of electrochemotherapy. In each course, bleomycin was injected intravenously (into the vein), following by 20 minutes of electric pulses, which were performed under local or general anesthesia. Patients were evaluated every 4 weeks for the 6 months following treatment, then every 3 months for up to 5 years. Outcomes measured included progression (tumor growth) of the disease; a partial response (a decrease in the size of the tumor), a complete response (disappearance of the tumor), or no change.

At 3 months following treatment, 38.3% of patients presented with a partial response, and 48.4% with a complete response. 44.8% of the patients with a complete response were disease free after 5 years. A measurable decrease in tumor size, was seen in 86.6% of all patients. No severe side effects were reported, though 36.6% of patients reported mild pain.

This study concluded that electrochemotherapy was a safe and effective treatment, with long-term benefits for cutaneous metastatic melanoma patients.

This study included a relatively small number of patients. Larger studies are needed in order to confirm these promising results.

Discuss with your physician whether electrochemotherapy is appropriate for your situation.