PMID- 28230715
DCOM- 20180312
LR  - 20180618
IS  - 1473-5636 (Electronic)
IS  - 0960-8931 (Linking)
VI  - 27
IP  - 3
DP  - 2017 Jun
TI  - A multireferral centre retrospective cohort analysis on the experience in
      treatment of metastatic uveal melanoma and utilization of sequential
      liver-directed treatment and immunotherapy.
PG  - 243-250
LID - 10.1097/CMR.0000000000000343 [doi]
AB  - Metastatic uveal melanoma is a rare malignancy with a poor prognosis. To date,
      systemic therapy has been ineffective; however, there are few data on the
      benefits of anti-CTLA4 or anti-PD-1 antibodies in sequence with liver-directed
      therapy. A retrospective cohort analysis was carried out on 37 consecutive
      patients managed in a tertiary referral centre examining the safety and efficacy 
      of treatment; patterns of care; and impact on survival. The sequential treatment 
      with transarterial chemotherapy (TAC), systemic immunotherapy (IT) and systemic
      chemotherapy was reviewed. In all, 18 patients in the series received sequential 
      therapy. The median overall survival (OS) was 17 months (n=37), which compared
      favourably with previously reported series. Patients treated with TAC first or
      second line had an overall progression-free survival (PFS) of 9 months (n=29) and
      IT PFS 7 months (n=26). The overall response rate (ORR) for TAC first line was
      26% and the disease control rate (DCR) was 65% (n=23). ORR for IT first line was 
      7%, DCR 77% (n=14). Second-line (cross-over) IT ORR was 16%, DCR 58% (n=12). For 
      second-line (cross-over) TAC, ORR was 50% and DCR was 66% (n=6). Toxicity was
      manageable. There were no cases of autoimmune hepatitis. In this retrospective
      small series analysis in uveal melanoma, liver-directed therapy and IT in
      sequence have shown to be active and reasonably well tolerated. Further
      prospective clinical trials should clarify the role of these treatments and their
      potential survival benefit.
FAU - Itchins, Malinda
AU  - Itchins M
AD  - aDepartment of Medical Oncology, Royal North Shore Hospital bDepartment of
      Medical Oncology Melanoma Institute Australia cDepartment of Medical Oncology,
      The University of Sydney, Sydney, New South Wales, Australia dDepartment of
      Medical Oncology, Istituto Nazionale Tumori 'Fondazione Pascale', Naples,
      Campania, Italy.
FAU - Ascierto, Paolo A
AU  - Ascierto PA
FAU - Menzies, Alexander M
AU  - Menzies AM
FAU - Oatley, Meredith
AU  - Oatley M
FAU - Lo, Serigne
AU  - Lo S
FAU - Douraghi-Zadeh, Dariush
AU  - Douraghi-Zadeh D
FAU - Harrington, Timmothy
AU  - Harrington T
FAU - Maher, Richard
AU  - Maher R
FAU - Grimaldi, Antonio M
AU  - Grimaldi AM
FAU - Guminski, Alexander
AU  - Guminski A
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - England
TA  - Melanoma Res
JT  - Melanoma research
JID - 9109623
RN  - Uveal melanoma
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - *Chemoembolization, Therapeutic
MH  - Combined Modality Therapy
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - *Immunotherapy
MH  - Liver Neoplasms/secondary/*therapy
MH  - Male
MH  - Melanoma/pathology/*therapy
MH  - Middle Aged
MH  - Prognosis
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Uveal Neoplasms/pathology/*therapy
EDAT- 2017/02/24 06:00
MHDA- 2018/03/13 06:00
CRDT- 2017/02/24 06:00
PHST- 2017/02/24 06:00 [pubmed]
PHST- 2018/03/13 06:00 [medline]
PHST- 2017/02/24 06:00 [entrez]
AID - 10.1097/CMR.0000000000000343 [doi]
PST - ppublish
SO  - Melanoma Res. 2017 Jun;27(3):243-250. doi: 10.1097/CMR.0000000000000343.