Altering Treatment Associated with Improved Outcomes in Uveal Melanoma Patients with Liver Metastasis

A recent study from Massachusetts Eye and Ear Infirmary found that the prognosis of patients with uveal melanoma that has metastasized is very poor, with a median survival of 3.9 months after diagnosis. The researchers also suggest that there has been no improvement in outcomes over decades of treatment for metastatic disease; however, with emerging research from The Sidney Kimmel Cancer Center-Jefferson Health, outcomes were shown to significantly improve with changes in treatment.

There is currently no FDA-approved treatment for metastatic uveal melanoma and systemic chemotherapy rarely induces a response in patients with metastatic disease, according to the study. Due to the lack of treatment options, researchers at Jefferson Health have experimented with treatments directed to the liver.

Instead of exposing the entire body to treatment, localized therapy targeting the liver allows the delivery of higher doses of medication to tumors. Moreover, cutting blood supply to the liver after delivering the medications via embolization provides additional damage to the tumors.

The researchers performed a retrospective review on patients with uveal melanoma with liver metastasis who were treated at Thomas Jefferson University Hospital during 3 time periods over 5 decades: 1971-1993 (cohort 1), 1998-2007 (cohort 2), and 2008-2017 (cohort 3).

In cohort 1, 70% of patients received only systemic chemotherapy, whereas 98% of patients in cohorts 2 and 3 received liver-directed treatments either alone or in combination with systemic therapy.

The study found that overall survival was shortest in cohort 1 (5.3 months), longer in cohort 2 (13.6 months), and longest in the more recent cohort 3 (17.8 months).

The researchers suggest that the shift of treatment modalities from systemic chemotherapy (cohort 1) to liver-directed treatments (cohorts 2 and 3) improved the survival of patients with uveal melanoma patients with liver metastasis. In addition, they suggest potential benefits of combining liver-directed therapies with newly emerging systemic therapies.

REFERENCE

Shift in treatment modalities associated with improved outcomes in uveal melanoma patients with liver metastasis [news release]. Philadelphia, PA; Thomas Jefferson University: February 3, 2020. https://www.jefferson.edu/about/news-and-events/2020/2/Shift-in-treatment-associated-with-improved-outcomes-in-uveal-melanoma-patients-with-liver-metastasis.html. Accessed February 5, 2020.