Yttrium-90 Radioembolization as a Safe and Effective Treatment Option for Hepatic Uveal Melanoma Metastases

Assessing the safety and efficacy of Yttrium-90 (⁹⁰Y) segmentectomy and lobar radioembolization as a treatment option for patients with hepatic uveal melanoma metastases.

An IRB-approved retrospective study of patients with liver metastases from uveal melanoma treated by radioembolization from 2017 to 2023 was performed. 25 patients (9 males, 16 females) with a median age at metastatic diagnosis of 62 years (range 30-78) underwent a total of 52 glass radioembolization procedures. Date of diagnosis and metastasis, tumor characteristics, concomitant therapies, treatment dosage, treatment related toxicities, survival, and imaging response were collected and reviewed. Imaging response was based on RECIST criteria as well as complete or partial radiographic response of the index tumor.

Mean index tumor size was 4.1 ± 1.0 cm (range 0.9-20). Complete radiographic response (n = 32) or partial response (n = 17) was achieved in 49/52 (94%) treatments. Segmental radioembolization showed higher rates of complete radiographic response compared to lobar radioembolization (78% vs. 35%, p < 0.05). Index tumor size was an independent factor in achieving optimal response rates for radiation segmentectomy (p < 0.05). Overall RECIST disease control rate was 84% (21/25). Median progression free survival and median overall survival from index treatment was 8.0 months (range 0.7-49.0) and 20.3 months (range 1.6-53.1), respectively. One year survival was 76% (19/25). Twelve mild Grade 1a clinical toxicities were reported (48%).

This study supports ⁹⁰Y radioembolization as a safe and effective treatment option for patients with hepatic metastatic uveal melanoma, with radiation segmentectomy achieving high rates of radiographic response and disease control rates.