KEY TAKEAWAYS
- The phase II trial aimed to present the institution’s experience in treating MUM pts with a combination of IE and an anti-PD1 antibody.
- Pts were treated with IE and IV Pembrolizumab every 4-6 weeks.
- The study found IE and checkpoint inhibitor therapy was a promising treatment for MUM pts with liver metastasis, with no reported immune-related liver toxicity.
Most metastatic uveal melanoma(MUM) patients(pts) have liver metastases associated with poor prognosis and poor survival. Controlling liver disease progression improves survival.
Researchers aimed to present the institution’s experience treating MUM pts with a combination of immuno-embolization(IE) and an anti-PD1 antibody (Pembrolizumab).
The study examined pts with MUM who received a combination of liver-directed therapy IE and IV Pembrolizumab. Pts selected for IE treatment had liver-predominant metastatic disease involving less than 50% of the total liver parenchyma, with a total bilirubin level of less than 2, serum albumin greater than 3, and an ECOG performance status of 0-1. Alternating lobar IE was administered every 4 weeks using a combination of GM-CSF (2000 mcg) and Lipiodol. Pembrolizumab was administered IV at a dose of 200 mg every 3 weeks.
In this study, 11 MUM pts received 58 IE treatments and IV Pembrolizumab. About 4 pts achieved stable disease, and 2 had a partial response as their best radiographic response during treatment. About 6 pts received additional lines of therapy, 4 participated in clinical trials, 5 pts were alive at the time of analysis, and 2 were actively receiving IE plus Pembrolizumab therapy. The median overall survival (OS) from diagnosis was 25.6 months, while the median OS from the first IE treatment was 21.3 months. Complications related to IE treatments included bleeding (n=1), severe post-procedural pain (n=2), infection (n=1), and an anaphylactic reaction (n=1). No unexpected side effects occurred with Pembrolizumab, and no immune-related hepatic toxicity was reported in any patient.
The study found IE and checkpoint inhibitor therapy is a promising treatment for MUM patients with liver metastasis, with no reported immune-related liver toxicity.
Source: https://ascopubs.org/doi/abs/10.1200/JCO.2023.41.16_suppl.e21592
Clinical Trial: https://clinicaltrials.gov/study/NCT03472586
Asad Javed, Chad Davis, Mohammad Amarneh, Michele T. Freesmeier, Bradley T. Loeffler, and Mohammed M. Milhem. DOI: 10.1200/JCO.2023.41.16_suppl.e21592 Journal of Clinical Oncology 41, no. 16_suppl (June 01, 2023) e21592-e21592.
