Liver Metastases from Melanoma: Hepatic Intra-Arterial Chemotherapy. A Retrospective Study

The liver is the primary site of metastases in most uveal melanoma patients. We retrospectively investigated intra-arterial chemotherapy (IAC) as treatment for patients with hepatic melanoma metastases. Twenty-three patients (18 with uveal melanoma) received fotemustine (14 patients, 61.9%) or carboplatin (9 patients, 31.1%) via hepatic LAC delivery. The catheter was introduced through percutaneous access to the femoral artery with drugs delivered directly to the hepatic artery, and was removed at the end of each treatment cycle. A total of 3 cycles was planned, repeated every 21 days. However, patients with a clinical response could receive more than 3 cycles, provided that the toxic effects were acceptable. IAC was well tolerated and no catheter-related complications or grade 4 toxicities were reported. Considering only uveal melanoma patients, the overall response rate and disease control rate was 16.7% and 38.9%, respectively. Median time to progression was 6.2 months (95% Cl 3.7-10.5) and median overall survival was 21 months (95% CI 8-39). IAC is well tolerated and is a valid choice for patients with a poor prognosis since median survival rates are among the longest reported.