Treatment Alternatives to Systemic Chemotherapy for Metastatic Uveal Melanoma
Posted: Tuesday, March 3, 2020
Shifting from systemic chemotherapies to localized therapy in one organ may improve survival outcomes in patients with metastatic uveal melanoma, suggests a single-institution study published in Cancers. Takami Sato, MD, PhD, Director of the Metastatic Uveal Melanoma Program at Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, and colleagues found higher overall survival in patients with uveal melanoma and liver metastasis who received liver-directed treatments rather than systemic chemotherapy. The researchers also noted that a combination of liver-directed treatments and systemic therapy may further improve outcomes.
“We are hoping that the addition of newly developed systemic therapies, especially immunotherapy, to liver-directed treatments, will further increase the survival of patients with this devastating disease,” stated Dr. Sato in a Thomas Jefferson University press release.
The retrospective study collected data from patients with uveal melanoma and liver metastases who received treatment at Thomas Jefferson Hospital. Patient data were categorized into three cohorts: cohort 1: 1971–1993 (n = 80); cohort 2: 1998–2007 (n = 198); and cohort 3: 2008–2017 (n = 452). Dacarbazine-based systemic therapy was given to 70% of patients in cohort 1, whereas 98% of patients in cohorts 2 and 3 received liver-directed treatment alone or in combination with systemic therapy.
Overall survival was shortest in cohort 1 (5.3 months), longer in cohort 2 (13.6 months), and longest in cohort 3 (17.8 months). After 1 year, patients in cohort 1 had a lower survival rate than those in cohorts 2 and 3 (23% vs. 59% vs. 67%). Investigators also found lower hazard of death rates in patients who received concurrent liver-directed and systemic treatments compared with patients who received liver-directed therapy alone (65%) or systemic therapy alone (72%).
The researchers acknowledged the possibility of result bias from performing a retrospective study at one institution. “Further investigation by way of prospective clinical trials is needed to answer these questions,” concluded the authors.
Disclosure: The study authors reported no conflicts of interest.