Adjuvant intra-arterial hepatic fotemustine for high-risk uveal melanoma patients

Verena Voelter*, Ann Schalenbourg, Sandro Pampallona, Solange Peters, Nermin Halkic, Alban Denys, Gudrun Goitein, Leonidas Zografos, Serge Leyvraz

*Corresponding author for this work

Research output: Contribution to journalArticle

40 Scopus citations

Abstract

Uveal melanoma metastases occur most commonly in the liver. Given the 50% mortality rate in patients at high risk of developing liver metastases, we tested an adjuvant intra-arterial hepatic (i.a.h.) chemotherapy with fotemustine after proton beam irradiation of the primary tumour. We treated 22 high-risk patients with adjuvant i.a.h. fotemustine. Planned treatment duration was 6 months, starting with four weekly doses of 100 mg/m, and after a 5-week rest, repeated every 3 weeks. The survival of this patient group was compared with that of a 3:1 matched control group randomly selected from our institutional database. Half of the patients experienced ≥ grade 3 hepatotoxicity (one patient developing cholangitis 8 years later). Catheter-related complications occurred in 18%. With a median follow-up of 4.6 years for the fotemustine group and 8.5 years for the control group, median overall survival was 9 years [95% confidence interval (CI) 2.2-12.7] and 7.4 years (95% CI 5.4-12.7; P=0.5), respectively, with 5-year survival rates of 75 and 56%. Treatment with adjuvant i.a.h. fotemustine is feasible. However, toxicities are important. Although our data suggest a survival benefit, it was not statistically significant. Confirming such a benefit would require a large, internationally coordinated, prospective randomized trial.

Original languageEnglish (US)
Pages (from-to)220-224
Number of pages5
JournalMelanoma Research
Volume18
Issue number3
DOIs
StatePublished - Jun 2008
Externally publishedYes

Keywords

  • Adjuvant chemotherapy
  • Intra-arterial hepatic fotemustine
  • Liver metastases
  • Uveal melanoma

ASJC Scopus subject areas

  • Oncology
  • Dermatology
  • Cancer Research

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  • Cite this

    Voelter, V., Schalenbourg, A., Pampallona, S., Peters, S., Halkic, N., Denys, A., Goitein, G., Zografos, L., & Leyvraz, S. (2008). Adjuvant intra-arterial hepatic fotemustine for high-risk uveal melanoma patients. Melanoma Research, 18(3), 220-224. https://doi.org/10.1097/CMR.0b013e32830317de