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Intra-arterial hepatic fotemustine for the treatment of liver metastases from uveal melanoma: experience in 101 patients

Peters, S. ; Voelter, V. ; Zografos, L. ; Pampallona, S. ; Popescu, R. ; Gillet, M. ; Bosshard, W. ; Fiorentini, G. ; Lotem, M. ; Weitzen, R. ; Keilholz, U. ; Humblet, Y. ; Piperno-Neumann, S. ; Stupp, R. ; Leyvraz, S.

In: Annals of Oncology, 2006, vol. 17, no. 4, p. 578-583

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    Titre
    • Intra-arterial hepatic fotemustine for the treatment of liver metastases from uveal melanoma: experience in 101 patients
    Auteur
    • Peters, S.. Centre Pluridisciplinaire d'Oncologie and
    • Voelter, V.. Centre Pluridisciplinaire d'Oncologie and
    • Zografos, L.. Hôpital Ophtalmique Jules Gonin, Lausanne, Switzerland
    • Pampallona, S.. ForMed, Evolène, Switzerland
    • Popescu, R.. Centre Pluridisciplinaire d'Oncologie and
    • Gillet, M.. Département de Chirurgie, University of Lausanne Hospitals (CHUV), Lausanne, Switzerland
    • Bosshard, W.. Centre Pluridisciplinaire d'Oncologie and
    • Fiorentini, G.. Ospedale Generale San Giuseppe, Empoli, Italy
    • Lotem, M.. Sharett Institute of Oncology, Hadassah Hebrew University Hospital, Jerusalem, Israel
    • Weitzen, R.. Sheba Medical Center, Tel Hashomer, Israel
    • Keilholz, U.. Medizinische Klinik II, Benjamin Franklin Hospital of the Free University, Berlin, Germany
    • Humblet, Y.. Centre du Cancer, St Luc University Hospital, Brussels, Belgium
    • Piperno-Neumann, S.. Institut Curie, Paris, France
    • Stupp, R.. Centre Pluridisciplinaire d'Oncologie and
    • Leyvraz, S.. Centre Pluridisciplinaire d'Oncologie and
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Annals of Oncology, 2006, vol. 17, no. 4, p. 578-583. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:291622
    Summary
    Background: Exclusive liver metastases occur in up to 40% of patients with uveal melanoma associated with a median survival of 2-7 months. Single agent response rates with commonly available chemotherapy are below 10%. We have investigated the use of fotemustine via direct intra-arterial hepatic (i.a.h.) administration in patients with uveal melanoma metastases. Patients and methods: A total of 101 patients from seven centers were treated with i.a.h. fotemustine, administered intra-arterially weekly for a 4-week induction period, and then as a maintenance treatment every 3 weeks until disease progression, unacceptable toxicity or patient refusal. Results: A median of eight fotemustine infusions per patient were delivered (range 1-26). Catheter related complications occurred in 23% of patients; however, this required treatment discontinuation in only 10% of the patients. The overall response rate was 36% with a median overall survival of 15 months and a 2-year survival rate of 29%. LDH, time between diagnosis and treatment start and gender were significant predictors of survival. Conclusions: Locoregional treatment with fotemustine is well tolerated and seems to improve outcome of this poor prognosis patient population. Median survival rates are among the longest reported and one-third of the patients are still alive at 2 years