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Melanoma

Melanoma Parallel Session

64: Hepatic and Overall Progression-Free Survival after Percutaneous Hepatic Perfusion as First-Line or Second-Line Therapy for Metastatic Uveal Melanoma

Thursday, March 21, 2024
2:37pm – 2:47pm ET
Location: C102

    Abstract Presenter(s)

  • Helana Ghali, BS

    Medical Student
    University of South Florida Morsani College of Medicine, University of South Florida, Tampa, FL, United States

    • Submitter(s)

  • Helana Ghali, BS

    Medical Student
    University of South Florida Morsani College of Medicine, University of South Florida, Tampa, FL, United States

    • Author(s)

  • Helana Ghali, BS

    Medical Student
    University of South Florida Morsani College of Medicine, University of South Florida, Tampa, FL, United States

  • MD

    Michelle M. Dugan, MD

    Research Fellow
    Cutaneous Oncology Department, Moffitt Cancer Center, Tampa, FL, United States

  • Shaliz Aflatooni, BS (she/her/hers)

    Medical Student
    University of South Florida Morsani College of Medicine, University of South Florida, Tampa, FL
    Tampa, Florida, United States

  • Aleena Boby, B.A. (she/her/hers)

    Medical Student
    University of South Florida Morsani College of Medicine, University of South Florida, Tampa, FL
    Tampa, Florida, United States

  • Danielle K. DePalo, MD (she/her/hers)

    Resident
    Department of General Surgery, University of Massachusetts Chan Medical School, Boston, MA, United States

  • JL

    Jose Laborde, PhD

    Senior Biostatistician
    Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa FL, United States

  • Jonathan S. Zager, MD

    Cutaneous Surgeon
    H. Lee Moffitt Cancer Center and Research Institute
    Tampa, Florida, United States

Disclosure(s):
Helana Ghali, BS: No financial relationships to disclose
Introduction:

Uveal melanoma has a high propensity to metastasize to the liver, portending a poor prognosis. Percutaneous hepatic perfusion (PHP) is an effective, minimally invasive means of isolating and circulating regional high-dose chemotherapy through the affected liver. This study evaluated outcomes based on PHP use as either first-line or second-line treatment, to help guide appropriate treatment sequencing.


Methods:

A retrospective review from a prospectively collected database was conducted, including adult patients with liver metastases from uveal melanoma treated with PHP from 2008 to 2023.


Results:

A total of 30 patients were identified, comprised of 53.3% female and 46.7% male, with a median age of 63.5 (37-78) years. Median follow-up time was 14.5 months. First-line therapies included PHP (n=17), liver-directed therapy (n=7), and immunotherapy (n=6). Second-line therapies included PHP (n=6), immunotherapy (n=5), and liver-directed therapy (n=3).

 

Median hepatic progression-free survival (hPFS) for first-line PHP, immunotherapy, and liver-directed therapy was 17.6, 8.8, and 9.2 months, respectively (p=0.002). Median hPFS for second-line PHP, immunotherapy, and liver-directed therapy were not reached, 14.7, and 7.5 months, respectively (p< 0.001).

 

Median overall PFS for first-line PHP, immunotherapy, and liver-directed therapy was 15.4, 8.8, and 9.2 months, respectively (p=0.04). Median overall PFS for second-line PHP, immunotherapy, and liver-directed therapy was 22.2, 14.7, and 7.5 months, respectively (p=0.001).


Conclusions:

PHP for metastatic uveal melanoma to the liver offers better hepatic disease control when used as first-line therapy compared to immunotherapy or liver-directed therapy. Furthermore, PHP offered superior overall disease control (overall PFS) when used as first-line therapy.

 

It was also notable that PHP continues to offer improved hepatic and overall disease control when used as a second-line treatment compared to second-line immunotherapy or liver-directed therapy, although the sample size was smaller.

Learning Objectives:

  • Upon completion, participant will be able to identify hepatic progression-free survival outcomes after first-line versus second-line percutaneous hepatic perfusion for patients with metastatic uveal melanoma.
  • Upon completion, participant will be able to identify overall progression-free survival outcomes after first-line versus second-line percutaneous hepatic perfusion for patients with metastatic uveal melanoma.
  • Upon completion, participant will understand how treatment sequencing with percutaneous hepatic perfusion impacts disease progression.