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Isolated Hepatic Perfusion as a Treatment for Liver Metastases of Uveal Melanoma
Published on: January 25, 2015
Hyperthermic isolated liver perfusion with melphalan and bevacizumab
T Voron1, F Zinzindohoué, D Journois
1Service de chirurgie générale, digestive et oncologique, Inserm CIE4, hôpital Européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France.
Journal of Visceral Surgery
|November 28, 2012
Summary
Hyperthermic Isolated Liver Perfusion (HILP) with melphalan and bevacizumab offers a promising treatment for unresectable liver tumors. This approach achieved complete tumor response in two challenging cases, indicating potential for advanced liver cancer therapy.
Area of Science:
- Oncology
- Vascular Biology
- Surgical Oncology
Background:
- Effective treatment for unresectable liver tumors with disease progression after chemotherapy is limited.
- Surgical resection remains the only curative option for liver tumors.
- Novel therapeutic strategies are needed for advanced liver malignancies.
Observation:
- Two patients with unresectable liver tumors (metastatic glucagonoma and recurrent hepatocellular carcinoma) were treated with a 1-hour Hyperthermic Isolated Liver Perfusion (HILP).
- The treatment combined melphalan with bevacizumab, an anti-VEGF antibody, targeting highly vascularized tumors.
- Enhanced CT scans demonstrated complete tumor necrosis by the second postoperative day.
Findings:
- Complete tumor response was observed in both patients following HILP.
- Disease-free survival was 27 months for metastatic glucagonoma and 7 months for HCC (prior to liver transplantation).
- Overall survival was 48 months for metastatic glucagonoma and 41 months for HCC (post-liver transplantation).
Implications:
- Bevacizumab in HILP can yield excellent tumor response in difficult liver tumor cases.
- This localized delivery method overcomes contraindications for combining bevacizumab with surgery.
- HILP represents a viable, targeted therapeutic option for select patients with advanced liver tumors.
