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IHP effectively treats unresectable metastases confined to liver

Isolated hepatic perfusion was an effective treatment for patients with uveal melanoma who developed unresectable metastases confined to the liver, according to a poster presentation at the European Society for Medical Oncology’s European Cancer Congress.

Researchers from Leiden University Medical Center and Erasmus Medical Centre, Surgery, Rotterdam, Netherlands, conducted a retrospective analysis on 30 patients with uveal melanoma liver metastases from two liver surgery centers between March 1999 and April 2009. The patients had previously been treated with isolated hepatic perfusion (IHP). In phase 2 trial in 2014, each patient was treated with percutaneous hepatic perfusion (PHP) twice daily during a 6-week interval, according to the abstract.

“Because of morbidity associated with the open procedure, a repeatable percutaneous system was developed and investigated in a phase 2 study,” the researchers wrote.

Both IHP and PHP treatments were performed with melphalan, and researchers analyzed treatment characteristics, complications, toxicity and overall survival.

Among patients who underwent IHP, recurrence occurred mainly in the liver, and overall survival was 10 months. The researchers said progression-free survival lasted 6 months.

Fifteen PHP procedures, which have been “well-tolerated,” have been performed in nine patients since February 2014. The maximum, current follow-up is 14 months. As of the presentation, eight patients were alive, and seven showed no disease progression. Small systemic leakage of melphalan led to a decrease in red and white blood cell count and thrombocytes after the procedure. Three patients needed blood transfusions or platelet infusion, according to the abstract.

“Overall survival after IHP was longer than previously reported in literature, and therefore we conclude that IHP is a treatment option for patients with unresectable metastases confined to the liver,” the researchers wrote. “Up to now, percutaneous hepatic perfusion appears to be an effective and safe procedure in selected patients with unresectable liver metastases of colorectal cancer or uveal melanoma and can be repeated.”

Reference:

De Leede EM, et al. Abstract 2247. Presented at: European Cancer Congress; Sept. 25-29, 2015; Vienna.

Disclosure: The researchers report no relevant financial disclosures.