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Campana LG, Quaglino P, de Terlizzi F, Mascherini M, Brizio M, Spina R, Bertino G, Kunte C, Odili J, Matteucci P, MacKenzie Ross A, Schepler H, Clover JAP, Kis E. Health-related quality of life trajectories in melanoma patients after electrochemotherapy: real-world insights from the InspECT register. J Eur Acad Dermatol Venereol 2022; 36:2352-2363. [PMID: 35870122 DOI: 10.1111/jdv.18456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 06/02/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Electrochemotherapy (ECT) effectively controls skin metastases from cutaneous melanoma. OBJECTIVES This study aimed to evaluate health-related quality of life (HRQoL) in melanoma patients pre-/post-ECT and its effect on treatment outcome. METHODS The analysis included prospective data from the International Network for Sharing Practices of ECT register. Following the Standard Operating Procedures, patients received intravenous or intratumoural bleomycin (15,000 IU/m2 ; 1000 IU mL/cm3 ) followed by 100-microsecond, 1000-V/cm electric pulses. Endpoints included response (RECIST v3.0), local progression-free survival (LPFS), toxicity (CTCAE v5.0), and patient-reported HRQoL at baseline, one, two, four and ten months (EuroQol [EQ-5D-3L], including 5-item utility score [EQ-5D] and visual analogue scale for self-reported health state [EQ-VAS]). Comparisons within/between subgroups were made for statistical and minimal important differences (MID). HRQoL scores and clinical covariates were analysed to identify predictors of response in multivariate analysis. RESULTS Median tumour size was 2 cm. Complete response rate, G3 toxicity and one-year LPFS in 378 patients (76% of the melanoma cohort) were 47%, 5%, and 78%. At baseline, age-paired HRQoL did not differ from the general European population. Following ECT, both EQ-5D and EQ-VAS scores remained within MID boundaries, particularly among complete responders. A subanalysis of the EQ-5D items revealed a statistically significant deterioration in pain/discomfort and mobility (restored within four months), and self-care and usual activities (throughout the follow-up) domains. Concomitant checkpoint inhibition correlated with better EQ-5D and EQ-VAS trajectories. Baseline EQ-5D was the exclusive independent predictor for complete response (RR 14.76, p=0.001). CONCLUSIONS HRQoL of ECT melanoma patients parallels the general population and is preserved in complete responders. Transient deterioration in pain/discomfort and mobility and persistent decline in self-care and usual activities may warrant targeted support interventions. Combination with checkpoint inhibitors is associated with better QoL outcomes. Baseline HRQoL provides predictive information which can help identify patients most likely to respond.
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Affiliation(s)
- L G Campana
- Department of Surgery, The Christie NHS Foundation Trust, Manchester, UK
- Department of Surgery, Manchester University NHS Foundation Trust, Manchester, UK
| | - P Quaglino
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Italy
| | - F de Terlizzi
- Biophysics Department, IGEA S.p.A., 41012 Carpi, Modena, Italy
| | - M Mascherini
- Department of Surgical Sciences, Polyclinic Hospital San Martino, Genoa, Italy
| | - M Brizio
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Italy
| | - R Spina
- Psychology Unit, University Hospital of Padua, Padua, Italy
| | - G Bertino
- Department of Otolaryngology-Head Neck Surgery, Policlinico San Matteo Foundation IRCCS, Pavia University, Pavia, Italy
| | - C Kunte
- Department of Dermatosurgery and Dermatology, Artemed Fachklinik, Munich, Germany
| | - J Odili
- Department of Plastic Surgery, St. Georges University Hospitals NHS Trust, London, UK
| | - P Matteucci
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - A MacKenzie Ross
- Department of Plastic and Reconstructive Surgery, St Thomas' Hospital, UK
| | - H Schepler
- Department of Dermatology, University Medical Center, Johannes Gutenberg University KöR, Mainz, Germany
| | - J A P Clover
- Department of Plastic Surgery, Cork University Hospital, Cork, Ireland
- Cancer Research, University College Cork, Cork, Ireland
| | - E Kis
- Department of Dermatology and Allergology, University of Szeged, Hungary
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Brizio M, Lora M, Freton A, Hudson M, Farge D, Colmegna I. Mesenchymal Stem/Stromal Cells: IN VITRO ANTI-FIBROTIC EFFECTS OF THE HUMAN MESENCHYMAL STROMAL CELLS’ SECRETOME. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00223-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Quaglino P, Fava P, Brizio M, Marra E, Rubatto M, Agostini A, Tonella L, Ribero S, Fierro MT. Metastatic melanoma treatment with checkpoint inhibitors in the COVID-19 era: experience from an Italian Skin Cancer Unit. J Eur Acad Dermatol Venereol 2020; 34:1395-1396. [PMID: 32426877 PMCID: PMC7276756 DOI: 10.1111/jdv.16586] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Linked articles: COVID‐19 SPECIAL FORUM. J Eur Acad Dermatol Venereol 2020; 34: e291–e310 .
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Affiliation(s)
- P Quaglino
- Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy
| | - P Fava
- Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy
| | - M Brizio
- Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy
| | - E Marra
- Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy
| | - M Rubatto
- Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy
| | - A Agostini
- Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy
| | - L Tonella
- Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy
| | - S Ribero
- Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy
| | - M T Fierro
- Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy
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Campana L, Quaglino P, Bechara F, Marconato R, Ascierto P, Caracò C, Brizio M, Clover J, Bourke M, Valpione S, Sersa G, Kunte C, Mühlstädt M, Gerlini G, Hafner J, Patuzzo R, Farronato S, Orlando A, Eisendle K, Kis E. Electrochemotherapy in melanoma: a European e-Delphi survey to define a consensus on indications, treatment modalities and quality indicators. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Rotunno R, Campana LG, Quaglino P, de Terlizzi F, Kunte C, Odili J, Gehl J, Ribero S, Liew SH, Marconato R, Brizio M, Curatolo P. Electrochemotherapy of unresectable cutaneous tumours with reduced dosages of intravenous bleomycin: analysis of 57 patients from the International Network for Sharing Practices of Electrochemotherapy registry. J Eur Acad Dermatol Venereol 2017; 32:1147-1154. [PMID: 29178483 DOI: 10.1111/jdv.14708] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 11/09/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Electrochemotherapy (ECT) is currently used to treat unresectable superficial tumours of different histotypes through the combination of cytotoxic chemotherapy and local application of electric pulses. In 2006, a collaborative project defined the ESOPE (European Standard Operating Procedures of Electrochemotherapy) guidelines to standardize the procedure. The International Network for Sharing Practices of Electrochemotherapy (InspECT) aims to refine the ESOPE and improve clinical practice. Limiting patient exposure to systemic chemotherapy would be advisable to ameliorate ECT safety profile. OBJECTIVE The aim of this study was to evaluate the efficacy and toxicity of ECT with reduced chemotherapy dosages. METHODS In a retrospective analysis of a prospectively maintained database (InspECT registry), we evaluated the outcome of patients who received ECT with reduced dosages of bleomycin (7500, 10 000 or 13 500 IU/m2 , instead of the standard dose of 15 000 IU/m2 ). Tumour response in melanoma patients was compared with melanoma patients of the InspECT registry who received the standard dose of bleomycin. RESULTS We identified 57 patients with 147 tumours (melanoma, 38.6%; squamous cell carcinoma, 22.8%; basal cell carcinoma, 17.5%; breast cancer 7%; Kaposi sarcoma 7%; other histotypes, 7.1%). Per-tumour complete response (CR) rate at 60 days was 70.1% (partial, 16.3%); per-patient CR was 57.9% (partial, 21.1%). Local pain was the most frequently reported side-effect (n = 22 patients [39%]), mostly mild; two patients experienced flu-like symptoms, one patient nausea. We observed the same CR rate (55%) in patients with melanoma treated by reduced or conventional bleomycin dosages (P = 1.00). CONCLUSIONS Electrochemotherapy performed with reduced bleomycin dosages could be as effective as with currently recommended dose. Patients with impaired renal function or candidate to multiple ECT cycles could benefit from a reduced dose protocol. Our findings need prospective confirmation before being adopted in clinical practice.
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Affiliation(s)
- R Rotunno
- Dermatologic Clinic, 'Sapienza' University of Rome, Rome, Italy
| | - L G Campana
- Department of Surgery Oncology and Gastroenterology (DISCOG), University of Padova, Padova, Italy.,Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - P Quaglino
- Dermatologic Clinic, Department Medical Sciences, University of Turin, Turin, Italy
| | - F de Terlizzi
- Scientific & Medical Department, IGEA S.p.A., Carpi, Modena, Italy
| | - C Kunte
- Department of Dermatologic Surgery and Dermatology, Artemed Fachklinik München, Munich, Germany.,Department of Dermatology and Allergology, Ludwig-Maximilian University Munich, Munich, Germany
| | - J Odili
- Plastic and Reconstructive Surgeon, St Georges' University Hospitals NHS Foundation Trust, London, UK
| | - J Gehl
- Center for Experimental Drug and Gene Electrotransfer, Department of Oncology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - S Ribero
- Dermatologic Clinic, Department Medical Sciences, University of Turin, Turin, Italy
| | - S H Liew
- Department of Plastic Surgery, Whiston Hospital, Liverpool, UK
| | - R Marconato
- Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - M Brizio
- Scientific & Medical Department, IGEA S.p.A., Carpi, Modena, Italy
| | - P Curatolo
- Dermatologic Clinic, 'Sapienza' University of Rome, Rome, Italy
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Kunte C, Letulé V, Gehl J, Dahlstroem K, Curatolo P, Rotunno R, Muir T, Occhini A, Bertino G, Powell B, Saxinger W, Lechner G, Liew SH, Pritchard-Jones R, Rutkowski P, Zdzienicki M, Mowatt D, Sykes A, Orlando A, Mitsala G, Rossi C, Campana L, Brizio M, de Terlizzi F, Quaglino P, Odili J. Electrochemotherapy in the treatment of metastatic malignant melanoma: a prospective cohort study by InspECT. Br J Dermatol 2017; 176:1475-1485. [DOI: 10.1111/bjd.15340] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2016] [Indexed: 12/16/2022]
Affiliation(s)
- C. Kunte
- Department of Dermatology and Allergology; Ludwig-Maximilian University; Munich Germany
| | - V. Letulé
- Department of Dermatology and Allergology; Ludwig-Maximilian University; Munich Germany
| | - J. Gehl
- Center for Experimental Drug and Gene Electrotransfer; Department of Oncology; Copenhagen University Hospital Herlev; Herlev Denmark
| | - K. Dahlstroem
- Department of Plastic Surgery; Copenhagen University Hospital Herlev; Denmark
| | - P. Curatolo
- Department of Dermatology and Plastic Surgery; Dermatologic Clinic; University of Rome ‘La Sapienza’; Rome Italy
| | - R. Rotunno
- Department of Dermatology and Plastic Surgery; Dermatologic Clinic; University of Rome ‘La Sapienza’; Rome Italy
| | - T. Muir
- Department of Reconstructive Plastic Surgery; James Cook University Hospital; Middlesbrough U.K
| | - A. Occhini
- Department of Otolaryngology Head & Neck Surgery; University of Pavia; IRCCS Policlinico San Matteo Foundation; Pavia Italy
| | - G. Bertino
- Department of Otolaryngology Head & Neck Surgery; University of Pavia; IRCCS Policlinico San Matteo Foundation; Pavia Italy
| | - B. Powell
- Department of Plastic Surgery; St George's Hospital; London U.K
| | - W. Saxinger
- Department of Dermatology; Klinikum Wels-Grieskirchen; Wels Austria
| | - G. Lechner
- Department of Dermatology; Klinikum Wels-Grieskirchen; Wels Austria
| | - S.-H. Liew
- Department of Plastic Surgery; Whiston Hospital; Prescot Merseyside U.K
| | | | - P. Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Warsaw Poland
| | - M. Zdzienicki
- Department of Soft Tissue/Bone Sarcoma and Melanoma; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Warsaw Poland
| | | | - A.J. Sykes
- Department of Clinical Oncology; Christie Hospital; NHS Foundation Trust; Manchester U.K
| | - A. Orlando
- Department of Plastic and Reconstructive Surgery; Southmead Hospital; North Bristol NHS Trust; Bristol U.K
| | - G. Mitsala
- Department of Plastic and Reconstructive Surgery; Southmead Hospital; North Bristol NHS Trust; Bristol U.K
| | - C.R. Rossi
- Veneto Institute of Oncology IOV-IRCCS; Padova Italy
- Department of Surgery, Oncology and Gastroenterology; University of Padova; Padova Italy
| | - L. Campana
- Veneto Institute of Oncology IOV-IRCCS; Padova Italy
- Department of Surgery, Oncology and Gastroenterology; University of Padova; Padova Italy
| | - M. Brizio
- Department of Medical Sciences; Dermatologic Clinic; University of Torino; Torino Italy
| | - F. de Terlizzi
- Scientific and Medical Department; IGEA S.p.A.; Carpi Italy
| | - P. Quaglino
- Department of Medical Sciences; Dermatologic Clinic; University of Torino; Torino Italy
| | - J. Odili
- Department of Plastic Surgery; St George's Hospital; London U.K
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Fava P, Bergallo M, Astrua C, Brizio M, Galliano I, Montanari P, Daprà V, Novelli M, Savoia P, Quaglino P, Fierro M. miR-155 expression in Primary Cutaneous T-Cell Lymphomas (CTCL). J Eur Acad Dermatol Venereol 2016; 31:e27-e29. [DOI: 10.1111/jdv.13597] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 11/17/2015] [Accepted: 12/04/2015] [Indexed: 02/05/2023]
Affiliation(s)
- P. Fava
- Section of Dermatology; Department of Medical Sciences; University of Turin; Turin Italy
| | - M. Bergallo
- Medical School; Department of Public Health and Pediatric Sciences; University of Turin; Turin Italy
| | - C. Astrua
- Section of Dermatology; Department of Medical Sciences; University of Turin; Turin Italy
| | - M. Brizio
- Section of Dermatology; Department of Medical Sciences; University of Turin; Turin Italy
| | - I. Galliano
- Medical School; Department of Public Health and Pediatric Sciences; University of Turin; Turin Italy
| | - P. Montanari
- Medical School; Department of Public Health and Pediatric Sciences; University of Turin; Turin Italy
| | - V. Daprà
- Medical School; Department of Public Health and Pediatric Sciences; University of Turin; Turin Italy
| | - M. Novelli
- Section of Dermatology; Department of Medical Sciences; University of Turin; Turin Italy
| | - P. Savoia
- Section of Dermatology; Department of Medical Sciences; University of Turin; Turin Italy
| | - P. Quaglino
- Section of Dermatology; Department of Medical Sciences; University of Turin; Turin Italy
| | - M.T. Fierro
- Section of Dermatology; Department of Medical Sciences; University of Turin; Turin Italy
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Fava P, Astrua C, Cavaliere G, Brizio M, Savoia P, Quaglino P, Fierro MT. Intestinal involvement in toxic epidermal necrolysis. A case report and review of literature. J Eur Acad Dermatol Venereol 2014; 29:1843-5. [PMID: 24754517 DOI: 10.1111/jdv.12535] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- P Fava
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Torino, Italy
| | - C Astrua
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Torino, Italy
| | - G Cavaliere
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Torino, Italy
| | - M Brizio
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Torino, Italy
| | - P Savoia
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Torino, Italy
| | - P Quaglino
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Torino, Italy
| | - M T Fierro
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Torino, Italy
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