Interim results of a pilot chemoradioembolisation study in uveal melanoma liver metastasis — ASN Events
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Interim results of a pilot chemoradioembolisation study in uveal melanoma liver metastasis (#154)

Sagun Parakh 1 2 3 4 , Miles Andrews 1 2 3 , Jodie Palmer 2 3 4 , Babak Tamjid 1 , Mark Goodwin 5 , Jonathan Cebon 1 2 3 4
  1. Medical Oncology, Austin Health, Melbourne, Victoria, Australia
  2. Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia
  3. Ludwig Institute for Cancer Research, Melbourne Branch, Melbourne, Victoria, Australia
  4. School of Cancer Medicine, La Trobe University , Melbourne, Victoria, Australia
  5. Department of Radiology, Austin Health, Melbourne, Victoria, Australia

Aim:

Uveal melanoma is the most commonprimary ocular malignancy in adults (1).  Patients with metastatic uveal melanoma have a 15% one-year survival with the majority relapsing in the liver (2). This characteristic of hepatic-only metastatic disease, coupled with poor response rates to chemotherapy, has led to the use of locoregional therapies directed at the hepatic metastases.

This study aims to utilize the radiosensitising properties of cisplatin, in combination with Yttrium-90 microspheres (SIR-Spheres® microspheres) radioembolisation, to maximize the therapeutic benefits achieved with targeted treatment of hepatic metastases in patients with uveal melanoma.

Methods:

Non-randomised pilot study of 10 patients with uveal melanoma and liver-only metastases treated with intrahepatic embolisation using SIR-Spheres® microspheres in combination with intravenous cisplatin.  Treatment-related adverse events and objective tumour response were analysed.

Results:

Four patients have been enrolled to date, with a mean age of 68 years (range 64-74). No patient had prior hepatic-directed therapies or systemic therapy. All patients had metastatic disease involving both lobes of the liver. Median duration of time from original diagnosis to SIR-Spheres® microspheres implantation was 24 months (range 18-60). The median SIR-Spheres® microspheres activity delivered was 1.75 GBq (range 1.42–1.7). The main systemic toxicities after treatment were low-grade (grade 1-2) fatigue, abdominal discomfort and nausea, all of which were self-limiting. Two patients experienced grade 3 abdominal pains post-microsphere implantation, which settled with supportive care. Using RECIST 1.1 criteria, there was an overall response rate of 75% in evaluable patients with 3 partial responses (PR) and 1 additional patient with stable disease (SD).  Two patients came off study due to extra-hepatic disease progression, with a mean duration of response of 6.5 months.

Conclusion:

SIR-Spheres® microspheres given concurrently with cisplatin as a radiosensitiser was well tolerated with initial response rates better than those reported in trials involving SIR-Spheres microspheres alone.

  1. Vajdic, C. M., Kricker, A., Giblin, M., McKenzie, J., Aitken, J., Giles, G. G. and Armstrong, B. K. (2003), Incidence of ocular melanoma in Australia from 1990 to 1998. Int. J. Cancer, 105: 117–122
  2. Sato T. Locoregional management of hepatic metastasis from primary uveal melanoma. Semin Oncol. 2010 Apr;37(2):127-38
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