Campana Luca G, Peric Barbara, Mascherini Matteo, Spina Romina, Kunte Christian, Kis Erika, Rozsa Petra, Quaglino Pietro, Jones Rowan Pritchard, Clover A James P, Curatolo Pietro, Giorgione Roberto, Cemazar Maja, Terlizzi Francesca de, Bosnjak Masa, Sersa Gregor
Department of Surgery, The Christie NHS Foundation Trust, Manchester M20 4BX, UK.
Department of Surgical Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia.
Cancers (Basel). 2021 Aug 25;13(17):4289. doi: 10.3390/cancers13174289.
Electrochemotherapy (ECT) is an effective locoregional therapy for cutaneous melanoma metastases and has been safely combined with immune checkpoint inhibitors in preliminary experiences. Since ECT is known to induce immunogenic cell death, its combination with immune checkpoint inhibitors might be beneficial. In this study, we aimed to investigate the effectiveness of ECT on cutaneous melanoma metastases in combination with pembrolizumab. We undertook a retrospective matched cohort analysis of stage IIIC-IV melanoma patients, included in the International Network for sharing practices of ECT (InspECT) and the Slovenian Cancer Registry. We compared the outcome of patients who received the following treatments: (a) pembrolizumab alone, (b) pembrolizumab plus ECT, and (c) ECT. The groups were matched for age, sex, performance status, and size of skin metastases. The local objective response rate (ORR) was higher in the pembrolizumab-ECT group than in the pembrolizumab group (78% and 39%, < 0.001). The 1 year local progression-free survival (LPFS) rates were 86% and 51% ( < 0.001), and the 1 year systemic PFS rates were 64% and 39%, respectively ( = 0.034). The 1 year overall survival (OS) rates were 88% and 64%, respectively ( = 0.006). Our results suggest that skin-directed therapy with ECT improves superficial tumor control in melanoma patients treated with pembrolizumab. Interestingly, we observed longer PFS and OS in the pembrolizumab-ECT group than in the pembrolizumab group. These findings warrant prospective confirmation.
电化学疗法（ECT）是一种治疗皮肤黑色素瘤转移灶的有效局部区域疗法，并且在初步试验中已安全地与免疫检查点抑制剂联合使用。由于已知ECT可诱导免疫原性细胞死亡，因此将其与免疫检查点抑制剂联合使用可能有益。在本研究中，我们旨在探讨ECT联合帕博利珠单抗治疗皮肤黑色素瘤转移灶的有效性。我们对纳入国际ECT实践共享网络（InspECT）和斯洛文尼亚癌症登记处的IIIC-IV期黑色素瘤患者进行了回顾性匹配队列分析。我们比较了接受以下治疗的患者的结局：（a）单独使用帕博利珠单抗，（b）帕博利珠单抗加ECT，以及（c）ECT。对各研究组的年龄、性别、体能状态和皮肤转移灶大小进行匹配。帕博利珠单抗-ECT组的局部客观缓解率（ORR）高于帕博利珠单抗组（分别为78%和39%，<0.001）。1年局部无进展生存率（LPFS）分别为86%和51%（<0.001），1年全身无进展生存率分别为64%和39%（P = 0.034）。1年总生存率（OS）分别为88%和64%（P = 0.006）。我们的结果表明，对于接受帕博利珠单抗治疗的黑色素瘤患者，ECT这种针对皮肤的治疗方法可改善浅表肿瘤控制。有趣的是，我们观察到帕博利珠单抗-ECT组的无进展生存期和总生存期比帕博利珠单抗组更长。这些发现有待前瞻性证实。
