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The incidence of melanoma has been increasing for more than 40 years and in the clinical course of this neoplasia cutaneous metastases are not unusual. Electrochemotherapy (ECT) is an already well recognised therapeutic tool for the local treatment of cutaneous and subcutaneous metastases of melanoma showing sustained anti-tumour activity and favourable toxicity profile. Treatment involves the local or intravenous administration of chemo therapeutic drugs followed by delivery of electrical pulses to the tumour. Recent advances in systemic therapies have dramatically modified melanoma therapeutic approach on stage III and IV with increased survival rates. However, the cutaneous metastases management still represents a challenge for clinicians due to pain, bleeding, odour and psychosocial distress related to the lesions but also for the limited efficacy on the skin offered by newly available systemic strategies. ECT may be considered for local tumour control as an alternative to established local treatments but it could be also favourably associated to immune and target therapies to improve their efficacy. Recent findings suggest indeed that electrochemotherapy may exert a role in boosting anti-tumour immunity and to avoid skin metastases resistance to systemic treatments.

Electrochemotherapy for the treatment of melanoma skin metastases in the era of new drugs