Australian Multicenter Study of Isolated Limb Infusion for Melanoma

Kroon, Hidde M.; Coventry, Brendon J.; Giles, Mitchell H.; Henderson, Michael A.; Speakman, David; Wall, Mark; Barbour, Andrew P.; Serpell, Jonathan W.; Paddle, Paul; Coventry, Alexander G. J.; Sullivan, Thomas; Smithers, B. Mark; Thompson, John F.

doi:10.1245/s10434-015-4969-2

Cited by 45 publications

(47 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The ORR of 86.6% is also favorable when compared with other IL therapies such as Bacille Calmette‐Guerin (BCG) immunotherapy (ORR 45%) and Talimogene Laherparepvec (T‐VEC), a herpes simplex virus type 1‐derived oncolytic immunotherapy (ORR 26.4%) . The overall response rate obtained in this study was similar to following isolated limb infusion (ORR 75%) and isolated limb perfusion (ORR 90%), accepting that these patients often have more extensive and bulky disease . Objectively, this treatment appeared to produce inferior results in terms of complete response and time to local progression compared to ILP .…”

Section: Discussionsupporting

confidence: 58%

Results of a phase II, open‐label, non‐comparative study of intralesional PV‐10 followed by radiotherapy for the treatment of in‐transit or metastatic melanoma

Foote

Read

Thomas

et al. 2017

Journal of Surgical Oncology

View full text Add to dashboard Cite

BACKGROUNDIn‐transit and recurrent dermal or subcutaneous melanoma metastases represent a significant burden of advanced disease. Intralesional Rose Bengal can elicit tumor selective ablation and a T‐cell mediated abscopal effect in untreated lesions. A subset of patients in a phase II trial setting received external beam radiotherapy to their recurrent lesions with complete or partial response and no significant acute radiation reaction.METHODSAn open‐label, single‐arm phase II study was performed to assess the efficacy and safety of PV‐10 followed by hypofractionated radiotherapy. Patients had in‐transit melanoma metastases suitable for IL therapy and radiotherapy.RESULTSFifteen patients were enrolled and thirteen completed both treatment components. The overall response rate was 86.6% and the clinical benefit was 93.3% on an intention to treat analysis (CR 33.3%, PR 53.3%, SD 6.7%). The median follow up duration was 19.25 months. Size of metastases (<10 mm) predicted lesion complete response (74.6%). Treatment was well tolerated with no associated grade 4 or 5 adverse events.CONCLUSIONSThe combination of PV‐10 and radiotherapy resulted in lesion‐specific, normal tissue‐sparing, ablation of disease with minimal local or systemic adverse effects.

show abstract

Section: Discussionsupporting

confidence: 58%

Results of a phase II, open‐label, non‐comparative study of intralesional PV‐10 followed by radiotherapy for the treatment of in‐transit or metastatic melanoma

Foote

Read

Thomas

et al. 2017

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

“…The limitation of the maximum temperature and the reduction of the rhTNFα dose, perfusion time, and perfused limb volume result in less systemic and local toxicity. In effect, the proportion of toxic grade III or IV reactions according to Wieberdink after ILPs with rhTNFα and melphalan is roughly equal to the toxicity of isolated limb infusion (ILI) with melphalan alone (Table ). TNF‐ILP is a neoadjuvant procedure. The understanding of destroying the sarcoma by destroying its vasculature is the key element of success.…”

Section: Current Standards In Tnf‐ilpmentioning

confidence: 99%

Role of isolated limb perfusion with recombinant human tumor necrosis factor α and melphalan in locally advanced extremity soft tissue sarcoma

Jakob

Hohenberger

2016

Cancer

View full text Add to dashboard Cite

Isolated limb perfusion with recombinant human tumor necrosis factor α and melphalan (TNF-ILP) is a highly effective regional treatment for locally advanced soft tissue sarcoma. This review critically discusses the indication for TNF-ILP. AbstractManagement of locally advanced extremity soft tissue sarcoma of the limbs is challenging particularly in recurrent tumors and those adjacent to neurovascular bundles and joints. Typically the tumors are large, below the fascia and of high grade (T2b, stage III according to AJCC) and thus require multimodal therapy. Treatment options must be tailored to patient and tumor characteristics.Isolated limb perfusion with recombinant human tumor necrosis factor α (TNF-ILP) adds a therapeutic option to radiation therapy and systemic chemotherapy. Although the procedure is somewhat sophisticated to learn, it is a safe method working for now almost two decades in more than 50 centers worldwide. TNF-ILP yields a high rate of pathologic complete or near-complete tumor remission. Combined with post-ILP surgical resection of the tumor remnant the limb salvage rate is close to 90%. Often adjuvant radiation therapy can be spared without compromising longterm local tumor control rates. Nevertheless, TNF-ILP has never been compared to other treatment regimen in a randomized trial. This review summarizes the mode of action and the standard application of TNF-ILP and focuses on a critical discussion on the role of TNF-ILP in multimodal treatment of locally advanced primary and recurrent extremity sarcoma.

show abstract

“…ILI is a form of regional limb chemotherapy developed in Sydney, Australia . A less invasive alternative to HILP, the procedure is also technically less challenging and has a reduced periprocedural morbidity profile . The results of our analysis reporting an ORR of 62% and local progression rate of 19% may underrepresent the true treatment outcomes as clinical assessments in examined studies were generally 3 months postintervention rather than at the time of the last follow‐up.…”

Section: Discussionmentioning

confidence: 89%

“…Table summarizes the key data for each modality and presents the pooled results including the weighted ORR and meta‐analysis data. Assessed studies included: randomized controlled trials, nonrandomized phase I and II comparative and noncomparative studies, and prospective or retrospective case series (NHMRC levels II–IV evidence; Tables S2‐S9) . Only two therapies: amputation and topical imiquimod, were suitable for formal meta‐analysis ( I 2 value ≤ 40%).…”

Section: Resultsmentioning

confidence: 99%

A systematic review and meta‐analysis of locoregional treatments for in‐transit melanoma

Read

Lonne

Sparks

et al. 2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

Background and Objectives In‐transit melanoma (ITM) metastases present a therapeutic challenge and management decisions can be difficult. There are multiple treatments available, with differing efficacy, and supported by different levels of evidence. The primary objective was to perform a systematic review and where suitable, a meta‐analysis of the literature reporting on the use of locoregional treatments for the management of ITM. Methods An independent review was conducted including a comprehensive search of the National Library of Medicine using PubMed, MEDLINE, Embase, and Cochrane Library databases. Key data were tabulated, synthesized and pooled to calculate relevant weighted effect sizes for each therapy using random‐effect models. The statistical heterogeneity was calculated using the Higgins' method. Results Of the initial 32 612 articles identified, 57 original articles satisfied eligibility criteria. Eight treatment modalities were identified comprising: amputation (7); hyperthermic isolated limb perfusion (15); isolated limb infusion (8); carbon dioxide laser (9); PV‐10 intralesional therapy (5); IL‐2 intralesional therapy (8); imiquimod (7); diphenylcyclopropenone (3). Only amputation and topical imiquimod were suitable for formal meta‐analysis. Conclusions All of the assessed therapies have significant selection bias. Variable levels of evidence support the ongoing use of locoregional treatments and these may significantly improve disease‐free survival.

show abstract

Australian Multicenter Study of Isolated Limb Infusion for Melanoma

Cited by 45 publications

References 35 publications

Results of a phase II, open‐label, non‐comparative study of intralesional PV‐10 followed by radiotherapy for the treatment of in‐transit or metastatic melanoma

Results of a phase II, open‐label, non‐comparative study of intralesional PV‐10 followed by radiotherapy for the treatment of in‐transit or metastatic melanoma

Role of isolated limb perfusion with recombinant human tumor necrosis factor α and melphalan in locally advanced extremity soft tissue sarcoma

A systematic review and meta‐analysis of locoregional treatments for in‐transit melanoma

Contact Info

Product

Resources

About