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Title: A pilot study of intrahepatic yttrium-90 microsphere radioembolization in combination with intravenous cisplatin for uveal melanoma liver-only metastases.
Austin Authors: Arulananda, Surein;Parakh, Sagun ;Palmer, Jodie ;Goodwin, Mark D ;Andrews, Miles C;Cebon, Jonathan S 
Affiliation: Olivia Newton-John Cancer Research Institute
Medical Oncology
Department of Medicine, University of Melbourne, Parkville, Victoria, Australia
School of Cancer Medicine, La Trobe University, Bundoora, Victoria, Australia
Issue Date: Aug-2019 2019-05-14
Publication information: Cancer Reports 2019; 2(4): e1183
Abstract: Metastatic uveal melanoma is a highly aggressive disease with no standard of care treatment option. A large proportion of patients have liver-only metastatic disease which raises the question if liver-directed therapy can be efficacious in this subpopulation. The study aims to evaluate the safety and efficacy of radiosensitizing chemotherapy in combination with yttrium-90 microspheres in patients with uveal melanoma with liver-only metastases. This single arm, open labeled, non-randomized study enrolled 10 patients with liver-only metastatic uveal melanoma between November 2012 and January 2018. Eligible patients received intrahepatic yttrium-90 microspheres followed by intravenous cisplatin (20 mg/m2) for 5 days. Ten patients were enrolled, but nine patients received treatment who were included in the final analysis with a median follow-up of 30 months (range 7 to 44). Five (50%) were female, five (50%) had an elevated lactate dehydrogenase (LDH), and one (10%) had prior anti-PD-1 therapy. The combination was well tolerated with no greater than or equal to grade 3 toxicity observed. The liver objective response rate (ORR) was 33% (3/9), the median progression-free survival (PFS) in the liver was 3 months (95% CI, 3-NA), and the extrahepatic PFS was 3 months (95% CI, 3-NA). Seventy-eight percent (7/9) received an immune checkpoint inhibitor on disease progression, with no responses seen. The median overall survival (OS) was 10 months (95% CI, 7-NA). The combination of cisplatin with yttrium-90 microspheres was well tolerated; however, it was associated with intrahepatic disease control of relatively short duration. No responses were seen in patients treated with immune checkpoint inhibitors post radioembolization.
DOI: 10.1002/cnr2.1183
ORCID: 0000-0002-5636-6381
PubMed URL: 32721131
Type: Journal Article
Subjects: anti‐PD‐1 therapy
uveal melanoma
yttrium‐90 microspheres
Appears in Collections:Journal articles

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