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Effective treatment of intractable cutaneous metastases of breast cancer with electrochemotherapy: Ten-year audit of single centre experience

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Abstract

Purpose

Electrochemotherapy (ECT) is the application of electric pulses to tumour tissue to render the cell membranes permeable to usually impermeant hydrophilic anti-cancer drugs, thereby enhancing cytotoxic effects. We sought to ascertain whether ECT can be an effective palliative treatment for cutaneous metastases of breast cancer.

Methods

This work reports data from the European Standard Operating Procedures for Electrochemotherapy trial (EudraCT Number: 2004-002183-18). In combination with systemic and/or intratumoural bleomycin, optimised electric pulses were delivered to locally recurrent or metastatic cutaneous breast cancer lesions. Follow-up continued until December 2014.

Results

Between February 2004 and December 2014, twenty-four patients were treated. All patients had received prior multimodal therapy. In total, the patient cohort had, or developed, 242 lesions. Two hundred and 36 lesions were treated, with 34 lost to follow-up. An objective response was seen in 161 of 202 lesions (79.7%), with a complete response observed in 130 (64.3%). Thirty-nine lesions (19.3%) did not respond, while 2 (1%) progressed following ECT. 17 (73.9%) patients received two or fewer treatments. A minimum of a partial response was seen in at least 50% of treated lesions in 18 of the 24 (75%) patients. Smaller lesions were more likely to have an objective response (Chi-square test for trend, p < 0.001).

Conclusions

Electrochemotherapy is an effective treatment for cutaneous breast cancer lesions that have proven refractory to standard therapies. As smaller lesions were found to be more responsive, we suggest that ECT should be considered as an early treatment modality, within multimodal treatment strategies.

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Abbreviations

CR:

Complete response

ECT:

Electrochemotherapy

IT:

Intratumoural

IV:

Intravenous

NC:

No change

NR:

No response

OR:

Objective response

PD:

Progressive disease

PR:

Partial response

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Acknowledgements

We wish to acknowledge the invaluable assistance provided by our research nurses, Alice Conroy and Claire Cronin, without whom this work would not have been possible. We also wish to acknowledge the guidance provided by Kathleen O’Sullivan, Lecturer & Director of The Statistical Consultancy Unit, School of Mathematical Sciences, University College Cork.

Funding

No funding was received for this work. This work was not supported by research grant monies.

Author information

Authors and Affiliations

  1. Cork Cancer Research Centre, Mercy University Hospital and Leslie C. Quick Jnr. Laboratory, Biosciences Institute, University College Cork, Cork, Ireland

    Mike G. Bourke, Slav P. Salwa, Mira Sadadcharam, Maria C. Whelan, Patrick F. Forde, John O. Larkin, Chris G. Collins, Gerald C. O’Sullivan, A. James Clover & Declan M. Soden

  2. Department of Oncology, Cork University Hospital and Mercy University Hospital, Cork, Ireland

    Seamus O’Reilly

  3. Department of Plastic Surgery, Cork University Hospital and South Infirmary Victoria University Hospital, Cork, Ireland

    A. James Clover

Authors
  1. Mike G. Bourke
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  2. Slav P. Salwa
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  3. Mira Sadadcharam
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  4. Maria C. Whelan
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  5. Patrick F. Forde
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  6. John O. Larkin
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  7. Chris G. Collins
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  8. Seamus O’Reilly
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  9. Gerald C. O’Sullivan
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  10. A. James Clover
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  11. Declan M. Soden
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Corresponding author

Correspondence to A. James Clover.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or National Research Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study. Additional informed consent was obtained from all individual participants for whom identifying information is included in this article. In accordance with the guidelines that guided participation in the ESOPE trial, each centre that wished to contribute data was required to obtain local ethics approval. Cork Cancer Research Centre was approved by both the Irish Medicines Board and the Cork Teaching Hospital Ethics Committee to research the application and study of electrochemotherapy in patients.

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Bourke, M.G., Salwa, S.P., Sadadcharam, M. et al. Effective treatment of intractable cutaneous metastases of breast cancer with electrochemotherapy: Ten-year audit of single centre experience. Breast Cancer Res Treat 161, 289–297 (2017). https://doi.org/10.1007/s10549-016-4046-y

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  • DOI: https://doi.org/10.1007/s10549-016-4046-y

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