2018 ASCO Annual Meeting!
Session: Melanoma/Skin Cancers
Type: Poster Session
Time: Monday June 4, 1:15 PM to 4:45 PM
Location: Hall A
Radioembolization for treatment of uveal melanoma hepatic metastasis: Results of a phase II, single institution, prospective trial.
2018 ASCO Annual Meeting
Poster Board Number:
Poster Session (Board #362)
J Clin Oncol 36, 2018 (suppl; abstr 9535)
Author(s): Carin F. Gonsalves, David J. Eschelman, Robert D. Adamo, P. Rani Anne, Marlana M. Orloff, Takami Sato; Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA; Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
Background: The liver is the first site of metastasis in > 90% of uveal melanoma (UM) patients. Transarterial catheter directed therapies have been used to control growth of liver tumors and prolong overall survival (OS). We report results of the first prospective, phase II trial using radioembolization ([RE] Y-90 resin microspheres) for treatment of UM hepatic metastases. Methods: Between November 2011 and January 2017, RE was performed on 24 treatment naïve patients [Group A (13 men; median age 63; range, 29 -77)] and 24 patients who progressed after immunoembolization [Group B (9 men; median age 59, range, 34-77)]. Patients received unilobar or lobar treatments separated by 3-5 weeks. Patients were followed for 1 month for acute toxicity and every 3 months for delayed toxicity (CTCAE v 3.0). MR, CT and PET imaging was obtained every 3 months to evaluate for tumor response (PFS; RECIST) and extrahepatic disease. Results: Group A: Unilobar (n = 7) or bilobar (n = 17) RE was performed (median dose, 32.6 mCi; range, 17.7-56.1). One patient was removed from the trial for incomplete lobar treatment. RE response included PR (n = 7), SD (n = 13) and PD (n = 3). Median PFS was 8.1 months (range, 3.3 - 33.7). Median OS was 18.9 months (range, 6.5 -66.9) with 4 surviving patients (range, 14.0-66.9 months). One year survival was 61%. Extrahepatic disease occurred in 17 patients (median, 6.3 months; range, 3.3 – 11.9). Group B: Unilobar (n = 5) or bilobar (n = 19) RE was performed (median dose, 35.0 mCi; range, 19.2 -50.8). RE response included PR (n = 6), SD (n = 8) and PD (n = 10). One patient withdrew from the trial. Median PFS was 4.3 months (range, 2.5 -18.6). Median OS was 19.1 months (range, 4.8-68.4) with 5 surviving patients (range, 18.6 – 68.4 months). One year survival was 70%. Extrahepatic disease occurred in 15 patients (median, 5.5 months; range 0.8-9.9). No procedure-related complications occurred. Grade 3 treatment-related toxicities included transient leukopenia (n = 2), nausea/vomiting (n = 1) and pain (n = 1). Conclusions: RE is a safe and effective treatment for UM hepatic metastases and should be considered as a treatment option for patients with and without prior transarterial catheter directed therapies. Clinical trial information: NCT01473004