The role of Electrochemotherapy in the treatment of patients with metastatic melanoma.
Patients who have advanced metastatic melanoma often present with multiple cutaneous metastases (CM), which are notoriously difficult to treat. These commonly present on the torso and the lower and upper limbs. However, systemic therapy alone can have limited efficacy in the treatment of CM. CM can cause significant morbidity including infection, bleeding, odour and pain. Many patients associate CM with the greatest effect on quality of life. 
Studies with Electrochemotherapy in metastatic melanoma patients
Several clinical studies demonstrate the efficacy and safety of Electrochemotherapy treatment with the CLINIPORATORTM in metastatic melanoma patients. 
Combination treatment in metastatic melanoma
Following Electrochemotherapy treatment, it has been observed that the release of tumour antigens can facilitate the immune response. Early clinical experiences indicate that this combination therapy can positively impact on patients’ long term survival.
Efficacy of Electrochemotherapy
Electrochemotherapy can be a single treatment option but also may be used multiple times if required. The treatment consists of a single intravenous injection of bleomycin followed by a local application of electrical pulses.
Analysis of the results from the European Register InspECT, for the treatment of multiple skin locations, states: “Notably, the local tumour control was 86% at 200 days of follow-up, meaning that patients with complete response maintained their response for a prolonged period of time”. 
Patients who show the best response to Electrochemotherapy
In 2013 NICE has published a recommendation about Electrochemotherapy where symptoms can be reduced and quality of life can be improved on selected patients:
“There is sufficient evidence of efficacy of electrochemotherapy for treating metastases in the skin from tumours of nonskin origin and melanoma to support its use as a palliative treatment. There are no major safety concerns. Therefore, in the context of palliative treatment the procedure can be used with normal arrangements for clinical governance, consent and audit”.
Electrochemotherapy in practice
The figures show a 58 years patient with multiple cutaneous metastases on the leg. Two months after the treatment with Electrochemotherapy, no HMB-45 cells were present in the treated area at the histologic analysis.
Treatment with Electrochemotherapy is particularly effective in patients with metastatic melanoma. Electrochemotherapy can be used in combination with immunotherapy and local therapies.
Treatment of metastatic melanoma has a significant positive effect on the patient’s quality of life. Electrochemotherapy is a fundamental and essential treatment within the therapeutic programme for patients with metastatic melanoma.
Information & Support
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