ASO Author Reflections: Percutaneous Hepatic Perfusion with Melphalan in Patients with Unresectable Hepatic Metastases from Ocular Melanoma

Abstract

Up to 50% of patients with ocular melanoma will develop metastatic disease with predominant liver involvement. Because effective systemic treatments are lacking, liver-directed therapies play a key role in the management of these patients. The superiority of percutaneous hepatic perfusion with melphalan (M-PHP) over best available care in controlling liver disease has been demonstrated in a randomized, controlled trial. 1 In this study, approximately 40% of patients had extrahepatic disease and M-PHP was associated with high rates of hematologic toxicity. To reduce the rate of hematologic toxicity following M-PHP, a new hemofiltration system with a second-generation detoxification cartridge (GEN 2 filter) was developed. So far, only retrospective studies have been published on this subject. 2-4