Ontology highlight
ABSTRACT: Background
Uveal melanoma (UM) has a poor prognosis once liver metastases occur. The melphalan/Hepatic Delivery System (melphalan/HDS) is a drug/device combination used for liver-directed treatment of metastatic UM (mUM) patients. The purpose of the FOCUS study was to assess the efficacy and safety of melphalan/HDS in patients with unresectable mUM.Methods
Eligible patients with mUM received treatment with melphalan (3.0 mg/kg ideal body weight) once every 6 to 8 weeks for a maximum of six cycles. The primary end point was the objective response rate (ORR). The secondary end points included duration of response (DOR), overall survival (OS), and progression-free survival (PFS).Results
The study enrolled 102 patients with mUM. Treatment was attempted in 95 patients, and 91 patients received treatment. In the treated population (n = 91), the ORR was 36.3 % (95 % confidence interval [CI], 26.44-47.01), including 7.7 % of patients with a complete response. Thus, the study met its primary end point because the lower bound of the 95 % CI for ORR exceeded the upper bound (8.3 %) from the benchmark meta-analysis. The median DOR was 14 months, and the median OS was 20.5 months, with an OS of 80 % at 1 year. The median PFS was 9 months, with a PFS of 65 % at 6 months. The most common serious treatment-emergent adverse events were thrombocytopenia (15.8 %) and neutropenia (10.5 %), treated mostly on an outpatient basis with observation. No treatment-related deaths were observed.Conclusion
Treatment with melphalan/HDS provides a clinically meaningful response rate and demonstrates a favorable benefit-risk profile in patients with unresectable mUM (study funded by Delcath; ClinicalTrials.gov identifier: NCT02678572; EudraCT no. 2015-000417-44).
SUBMITTER: Zager JS
PROVIDER: S-EPMC11249544 | biostudies-literature | 2024 Aug
REPOSITORIES: biostudies-literature
Zager Jonathan S JS Orloff Marlana M Ferrucci Pier Francesco PF Choi Junsung J Eschelman David J DJ Glazer Evan S ES Ejaz Aslam A Howard J Harrison JH Richtig Erika E Ochsenreither Sebastian S Reddy Sunil A SA Lowe Michael C MC Beasley Georgia M GM Gesierich Anja A Bender Armin A Gschnell Martin M Dummer Reinhard R Rivoire Michel M Arance Ana A Fenwick Stephen William SW Sacco Joseph J JJ Haferkamp Sebastian S Weishaupt Carsten C John Johnny J Wheater Matthew M Ottensmeier Christian H CH
Annals of surgical oncology 20240504 8
<h4>Background</h4>Uveal melanoma (UM) has a poor prognosis once liver metastases occur. The melphalan/Hepatic Delivery System (melphalan/HDS) is a drug/device combination used for liver-directed treatment of metastatic UM (mUM) patients. The purpose of the FOCUS study was to assess the efficacy and safety of melphalan/HDS in patients with unresectable mUM.<h4>Methods</h4>Eligible patients with mUM received treatment with melphalan (3.0 mg/kg ideal body weight) once every 6 to 8 weeks for a maxi ...[more]