Uveal melanoma is a rare type of cancer that grows in the melanin, the dark-colored pigment of the eye. About half of patients with uveal melanoma experience metastasis characterized by the spread of cancer cells to distant parts of the body. The liver is the most commonly inflicted secondary organ in metastatic uveal melanoma (mUM). Sadly, 75 – 90% of mUM cases prove fatal.
Currently, there is no standard-of-care treatment for mUM and developing an efficacious treatment modality remains a research focus. Immunotherapies are used in some cases, but they garner less than a 20% response rate in treating mUM. Percutaneous hepatic perfusion of melphalan (M-PHP) has emerged as a promising investigative technique for treating liver metastasis. M-PHP has many benefits, including that it is a minimally invasive procedure that typically results in minimal adverse effects. Initial trials suggest M-PHP could significantly benefit patients with liver metastases.
M-PHP administers chemotherapy directly to the liver to treat liver cancer or liver metastases. Because the liver is soaked, or “saturated”, with high-dose chemotherapy, this technique is considered “chemosaturation” therapy.
Doctors insert a thin tube, known as a cannula, into the hepatic artery, the blood vessel that delivers oxygenated blood to the liver and pancreas. Melphalan, a chemotherapy, is then delivered to the liver via the cannula. To limit damage to healthy tissue throughout the body, doctors will perform a venobenous bypass procedure. The chemotherapy-infused blood exiting the liver is collected, the harmful chemotherapeutic metabolites are filtered out, and the blood is returned to the patient, re-entering normal circulation.