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. (pictured), associate professor of surgery, University of Pittsburgh School of Medicine, and surgical oncologist with UPMC Cancer Centers.
"Once melanoma spreads to the liver, a patient's life expectancy typically ranges from 6 to 9 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."
Illustration: University of Pittsburgh Medical Center.
University of Pittsburgh Medical Center Cancer Centers News Release (06/05/10)
Science Daily (06/07/10)
Medical News Today (06/07/10)
Abstract (2010 American Society of Clinical Oncology Annual Meeting; LBA8512, S406 Vista Room, 1:00PM-4:00PM (06/05/10))