Chemotherapy delivered directly into liver blood vessels increases progression-free survival in melanoma patients

Patients undergoing treatment for melanoma that has spread to the liver may respond well to chemotherapy delivered directly into the liver's blood vessels, according to a study sponsored by the National Cancer Institute and Delcath Systems Inc., and led by James F. Pingpank, M.D., associate professor of surgery, University of Pittsburgh School of Medicine, and surgical oncologist with UPMC Cancer Centers. The results will be disclosed in an oral presentation on June 5 in Chicago at the 46th annual meeting of the American Society of Clinical Oncology (ASCO).

"Once melanoma spreads to the liver, a patient's life expectancy typically ranges from six to nine months," said Dr. Pingpank. "We hoped this study would not only show an increase in progression-free survival rates for these patients, but also lead to a standard of care for the disease."

The phase III trial enrolled 93 patients from 10 different sites across the country between February 2006 and October 2009. Its primary goal was to double the length of hepatic progression-free survival for patients with melanoma that had spread to the liver. Patients received either percutaneous hepatic perfusion (PHP) with the drug melphalan, meaning the chemotherapy was delivered directly into the blood vessels of the liver, or the treatment considered the best alternative regimen by their treating physician. If a patient not receiving PHP had disease progression, he or she could cross over to the PHP arm of the trial.

"Not only did we achieve our goal, we surpassed it," said Dr. Pingpank. "This is particularly exciting because so far oncologists haven't been able to recommend a standard of care for patients with melanoma that has spread to the liver. PHP appears to control tumors in the liver and extend life expectancy for these patients, whether their melanoma began as skin cancer or as ocular melanoma, a less common form of the disease that starts in the eye. Fifty percent of ocular melanoma patients will experience liver metastasis, so these findings are crucial for them."

Melanoma is a rare form of cancer, but it causes the majority of skin cancer-related deaths. Each year, approximately 160,000 new cases are diagnosed worldwide. Ocular melanoma will be diagnosed in approximately 2,500 adults this year.

This study is published as Abstract Number LBA8512 in the 2010 Annual Meeting Proceedings.

Other sites involved in the study include the Surgery Branch of the NCI, Bethesda, Md.; John Wayne Cancer Institute, Santa Monica, Calif.; H.Lee Moffitt Cancer Center, Tampa, Fla.; University School of Maryland Medicine, Baltimore; The University of Texas M.D. Anderson Cancer Center, Houston; Atlantic Melanoma Center, Morristown, N.J.; Rad Imaging Associates, Englewood, Colo.; Albany Medical Center Hospital, Albany, N.Y.; and St. Luke's Hospital and Health Network in Bethlehem, Pa.