367P - Electrochemotherapy for chest wall recurrence from breast cancer in older women: analysis of 55 patients

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Breast Cancer, Metastatic
Geriatric Oncology
Presenter Luca Campana
Authors L.G. Campana1, S. Galuppo2, S. Valpione3, C. Falci4, L. Corti2, A. Brunello5, G. Zavagno6, C. Ghiotto7, C.R. Rossi8
  • 1Veneto Region Oncology Research Institute (IOV-IRCCS), 35128 - Padova/IT
  • 2Radiotherapy Unit, Veneto Region Oncology Research Institute (IOV-IRCCS)), Padova/IT
  • 3University of Padova, Padova/IT
  • 4Oncologia Medica 2, Veneto Region Oncology Research Institute (IOV-IRCCS), Padova/IT
  • 5Medical Oncology Unit-i, Veneto Region Oncology Research Institute (IOV-IRCCS)), Padova/IT
  • 6Dept. Of Surgery And Gastroenterological Sciences, University Of Padova, Surgery Branch, Padova/IT
  • 7Medical Oncology-ii, Veneto Region Oncology Research Institute (IOV-IRCCS), Padova/IT
  • 8Sarcoma And Melanoma Unit, Veneto Region Oncology Research Institute (IOV-IRCCS), 35128 - Padova/IT

Abstract

Background

The incidence of chest wall recurrence (CWR) after mastectomy for breast cancer (BC) ranges from 5 to 40%. It is a common finding that a number of patients are not suitable for radical resection or full-dose radiotherapy. When resistance to systemic therapies occurs, electrochemotherapy (ECT), an electroporation-based local drug delivery system, could represent a valuable treatment option for older women.

Methods

We analyzed a prospectively maintained database of 55 BC patients (median 70 years, range 38-88) with irresectable CWR who experienced disease progression after at least 2 lines of systemic therapies. Tumor response, response duration and toxicity profile were analyzed according to patients' age (<70 vs >70 years).

Results

The patients received a median of 2 ECT courses (range, 1-5). Younger (n = 27) and elderly (n = 28) patients were comparable for clinico-pathological features, except for the number of CW metastases (median 15 vs 8, respectively, P = .040). Two-month objective response was: complete 22 patients (40.0%), partial 26 (47.3%), no change 7 (12.7%). The complete response rate was significantly higher in the elderly group (57.7 vs 28%, P = .02). Pain and local toxicity scores were similar, but worsened with the increasing number of ECT applications. Median follow-up was 32 months (range, 6–53), 3-year local control rate was 70%. Thirty-three patients (60%) developed new lesions (NL) in non-electroporated areas (median, 6.6 months). Less than 10 metastases (P < .001), the narrower area of tumor spread on the CW (P = .022), endocrine- instead of chemotherapy (P = .025) and complete response after ECT (P = .019) were associated to longer NL-free survival. Older women showed a trend to a lower local tumor control compared to younger patients (2-year local progression-free survival, 83 versus 88%, P = .120). On the contrary, elderly patients reported a better 2-year NL-free survival (45 versus 22%, P = .095).

Conclusions

Older patients with CWR present fewer skin metastases and are more likely to achieve complete response after ECT. The satisfactory CW control without severe toxicity makes elderly women with refractory CWR suitable candidates for ECT application.

Disclosure

All authors have declared no conflicts of interest.