Electrochemotherapy with bleomycin for basal cell carcinomas: a systematic review

Area of Science:

• Oncology
• Dermatology
• Cancer Treatment

Background:

• Basal cell carcinoma (BCC) is the most prevalent cancer globally.
• Increasing BCC incidence necessitates exploration of novel therapeutic strategies.
• Electrochemotherapy (ECT) with bleomycin emerges as a potential treatment option.

Purpose of the Study:

• To systematically review existing literature on bleomycin-electrochemotherapy for basal cell carcinoma treatment.
• To assess the efficacy and safety of bleomycin-ECT based on available evidence.
• To identify research gaps and recommend future study directions.

Main Methods:

• Systematic literature search across MEDLINE, Embase, Web of Science, and Cochrane databases.
• Inclusion of 32 studies on bleomycin-ECT for BCC, categorized by evidence level.
• Analysis of study designs including one randomized controlled trial (RCT), uncontrolled trials, registry studies, and case series.
• Classification of studies based on bleomycin administration routes (intravenous, intralesional).

Main Results:

• The single RCT demonstrated a 92% complete response rate for BCC after 2 months, increasing to 100% post-retreatment.
• Recurrence rates were observed to be low in the bleomycin-ECT treated BCC cohort.
• Heterogeneity of studies precluded a meta-analysis, but findings were consistent across study types.

Conclusions:

• Bleomycin-ECT shows significant potential as an effective treatment for basal cell carcinoma.
• Future research should prioritize large-scale randomized controlled trials comparing bleomycin-ECT to standard treatments.
• Further investigation into cost-effectiveness and clinical feasibility of bleomycin-ECT is warranted.