ORIGINAL ARTICLESChemoembolization of the hepatic artery with BCNU for metastatic uveal melanoma: results of a phase II studyPatel, Kashyapa; Sullivan, Kevinb; Berd, Davida; Mastrangelo, Michael J.a; Shields, Carol L.c; Shields, Jerry A.c; Sato, TakamiaAuthor Information aDivision of Medical Oncology, Department of Medicine bDivision of Interventional Radiology, Department of Radiology cDivision of Ocular Oncology, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA Correspondence and requests for reprints to Dr Takami Sato, Division of Medical Oncology, Thomas Jefferson University, 1025 Walnut Street, Suite 1024, Philadelphia, PA 19107, USA Tel: 215-955-8875; fax: 215-923-9127; e-mail: [email protected] Received 2 July 2004 Accepted (after revision) 19 January 2005 Melanoma Research: August 2005 - Volume 15 - Issue 4 - p 297-304 Buy Abstract Uveal melanoma is the most common primary intraocular malignancy in adults and the liver is the most common site for systemic metastases. We conducted a phase II clinical trial for patients with hepatic metastases from uveal melanoma using chemoembolization of the hepatic artery with 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) dissolved in ethiodized oil. Gelatin sponge particles were used as a transiently occlusive agent. The responses in hepatic metastases, overall survival, time to progression and side-effects related to chemoembolization were evaluated. Thirty patients were enrolled. Twenty-four patients completed at least one treatment to all targeted liver metastases and were evaluable for hepatic response. Eighteen of these 24 patients experienced regression or stabilization of hepatic metastases for at least 6 weeks (one complete response in hepatic metastases; four partial responses; 13 stable disease). One of the 13 patients with stable disease was rendered free of disease by surgical removal of metastases after chemoembolization (surgical complete response). The overall response rates (complete and partial responses) for intention-to-treat patients and for patients who were evaluable for response were 16.7 and 20.4%, respectively. The median overall survival of the entire intention-to-treat group of patients was 5.2 months (range, 0.1–27.6 months), for patients with complete or partial response in hepatic metastases 21.9 months (range, 7.4–27.6 months), for patients with stable disease 8.7 months (range, 2.9–14.4 months) and for patients with progressive disease 3.3 months (range, 1.6–5.6 months). Importantly, 13 of the 18 patients who achieved complete response, partial response or stable disease subsequently developed progression of extrahepatic metastases with control of hepatic metastases. Chemoembolization with BCNU is a useful palliative treatment for the control of hepatic metastases in uveal melanoma patients. However, progression in extrahepatic sites after stabilization of hepatic metastases requires further improvement in the therapeutic approach to this disease. © 2005 Lippincott Williams & Wilkins, Inc.