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P47. Outcomes of Percutaneous Hepatic Perfusion with Melphalan for Metastatic Uveal Melanoma to the Liver: Post FDA Approval Real World Data

Thursday, March 5, 2026
3:07 PM - 3:14 PM MST
Location: 301D

    Primary Author(s)

  • Lacey Mead, DO, MS

    Surgical Oncology Research Fellow
    Moffitt Cancer Center
    Lakeland, Florida, United States

    Slides

    • Co-Author(s)

  • Parker Olive, BS

    Medical Student, University of South Florida
    University of South Florida
    Tampa, Florida, United States

  • AH

    Alexis Hernandez-Flores, BS

    Medical Student
    University of South Florida Morsani College of Medicine
    Tampa, Florida, United States

  • Caitlyn N. Balsay-Patel, MD

    Surgical Oncology Research Fellow
    Moffitt Cancer Center
    Tampa, Florida, United States

  • Michelle M. Dugan, MD

    General Surgery Resident
    University of Florida
    Gainesville, Florida, United States

  • AA

    Altan Ahmed, MD

    Interventional Radiologist, Department of Diagnostic Imaging and Interventional Radiology
    Moffitt Cancer Center
    Tampa, Florida, United States

  • JC

    Junsung Choi, MD

    Department of Diagnostic Imaging and Interventional Radiology
    Moffitt Cancer Center
    Tampa, Florida, United States

  • Zeynep Eroglu, MD

    Medical Oncologist, Department of Cutaneous Oncology
    Moffitt Cancer Center
    Tampa, Florida, United States

  • JM

    Joseph Markowitz, MD, PhD

    Medical Oncologist, Department of Cutaneous Oncology
    Moffitt Cancer Center
    Tampa, Florida, United States

  • NK

    Nikhil Khushalani, MD

    Vice Chair Department of Cutaneous Oncology
    Moffitt Cancer Center
    Tampa, Florida, United States

  • Ahmad Tarhini, MD, PhD

    Director, Cutaneous Clinical and Translational Research
    Moffitt Cancer Center
    Tampa, Florida, United States

  • LK

    Lilit Karapetyan, MD, MS

    Medical Oncologist, Department of Cutaneous Oncology
    Moffitt Cancer Center
    Tampa, Florida, United States

  • MP

    Matthew C. Perez, MD

    Surgical Oncologist, Department of Cutaneous Oncology
    Moffitt Cancer Center
    Tampa, Florida, United States

    • Primary Author(s)

  • MA

    Mohammed Alomar, MD

    Director, Department of Cardio-Oncology
    Moffitt Cancer Center, Universtiy of South Florida
    Tampa, Florida, United States

  • Jonathan S. Zager, MD, FACS

    Chief Academic Officer and Chair of Department of Oncologic Sciences
    Moffitt Cancer Center
    Tampa, Florida, United States

    • Co-Author(s)

  • AS

    Anna Stoshak, PA-C

    Physician Assistant - Cutaneous Oncology Department
    Moffitt Cancer Center
    Tampa, Florida, United States

    • Primary Presenter(s)

  • Lacey Mead, DO, MS

    Surgical Oncology Research Fellow
    Moffitt Cancer Center
    Lakeland, Florida, United States

    Slides
Introduction: Uveal melanoma (UM) has a high propensity to metastasize (mUM) to the liver, leading to a poor prognosis. Percutaneous hepatic perfusion (PHP), a minimally invasive technique to isolate and saturate the liver with high-dose melphalan, approved in August 2023 for hepatic dominant mUM. We report our experience with PHP post FDA approval to present. 


Methods: A retrospective review of a prospective database evaluating patients who underwent PHP. Data collected: demographic, imaging, treatment characteristics to assess progression free survival (PFS), disease specific survival (DSS), Overall Response Rate (complete response/partial response) and Disease Control Rate (complete response/partial response/stable disease) from first to last PHP, and adverse effects.


Results: Eighteen p</span>atients underwent a total of 81 PHPs with a median of 4.5 PHPs (range, 1-7). The median age was 66.5 (41-76); 72% female. The median time from UM to mUM was 33 mo (range, 7-199), and median time from mUM to first PHP was 2.5 mo (range 1-27). Four (22%) had previously been treated for mUM prior to PHP; 2 with immunotherapy, 1 with liver resection, and 1 with immunoembolization. PHP was well tolerated with minimal toxicity; 1 had fluid overload/pulmonary edema, 1 G3 thrombocytopenia requiring transfusion, and 5 with G1 bone marrow suppression. All patients had complete resolution of toxicities except 1 with prolonged G1 cytopenia. Median hospital length of stay was 1 day (range,1-3). Median follow up from first PHP was 8 mo (range, 2 to 30). Eight (44%) p</span>ts completed 6 PHPs every 6-8 weeks. Four (22%) discontinued due to progression of disease (PD) and 1 (6%) secondary to DVT/PE. Six (33%) have ongoing PHP. Hepatic ORR was 44% and DCR was 83%. The median intrahepatic and extrahepatic PFS was 11 and 10.5 mo.  One pt died of disease, median DSS not reached. To date, 5 (28%) pts have not progressed. While being treated with PHP, 4 pts progressed with extrahepatic disease, all successfully treated with SBRT or resection, and PHP continued. Five (28%) pts developed extrahepatic progression after completing 6 PHPs; all treated with SBRT. One pt received 7 PHPs after progression in liver 2 years after first PHP.


Conclusions: PHP achieves excellent hepatic DCR and PFS. Extrahepatic progression with control of liver disease during PHP, can be treated with resection or SBRT while undergoing additional PHPs. The majority of patients complete 6 PHPs with minimal toxicity.

Learning Objectives:

  • Be able to discern clinicopathological outcomes of PHP for metastatic uveal melanoma to the liver
  • PHP continues to showcase excellent survivorship outcomes, improved PFS and OS for those with metastatic uveal melanoma
  • Minimal toxicity is currently observed with PHP