A new experimental treatment offers some hope for patients with ocular melanoma that has metastasized to the liver.
Ocular melanoma is the most common eye cancer in adults. About 50% of patients diagnosed with ocular melanoma go on to develop metastatic disease. In 95% of cases, the liver is the first place metastases are discovered. This is because ocular melanoma spreads through the blood-stream as opposed to the lymphatic system, making the liver susceptible to metastasis.
A patient’s prognosis is generally poor once the melanoma spreads. According to the Ocular Melanoma Foundation, median survival time is between two and eight months without treatment. Standard chemotherapy tends to be ineffective, but a new experimental therapy called percutaneous hepatic perfusion (PHP) shows promise. It is now undergoing clinical trials led by the National Cancer Institute.
In PHP, doctors isolate the liver and fill it with the chemotherapy drug Melphalan. During the procedure, a catheter with a balloon on either end is inserted through several needle punctures in the skin. The balloons are then inflated, sealing off the vein above and below the liver. Once isolated, high-dose, heated chemotherapy is infused through the liver. Charcoal filters remove chemotherapy from the blood as it is returned to the body through a second catheter in the neck.
A 2010 study published in the American Journal of Clinical Oncology revealed the potential benefits of using PHP to treat both ocular and skin melanomas that have metastasized in the liver. In the study, researchers concluded the treatment significantly improved progression-free survival rates compared to the best available options.
Clinical trials have reinforced cause for optimism. In one case, Sabrina Frey, 43, recently underwent PHP treatment at Moffitt Cancer Center in Tampa, Florida. She was featured in news reports across the country and says the treatment visibly reduced her tumors.
“Some tumors are not actually even visible on my MRI’s anymore,” Sabrina said.
While PHP seems to have reduced the size of metastatic ocular melanoma tumors in the liver, it is not a cure. Researchers say the earlier the treatment is started, the better the outcome. It seems to be most successful in patients with strong liver function and a limited number of metastatic tumors.