Efficacy and Safety of the Melphalan/Hepatic Delivery System in Patients with Unresectable Metastatic Uveal Melanoma: Results from an Open-Label, Single-Arm, Multicenter Phase 3 Study.

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Title: Efficacy and Safety of the Melphalan/Hepatic Delivery System in Patients with Unresectable Metastatic Uveal Melanoma: Results from an Open-Label, Single-Arm, Multicenter Phase 3 Study.
Authors: Zager, Jonathan S., Orloff, Marlana, Ferrucci, Pier Francesco, Choi, Junsung, Eschelman, David J., Glazer, Evan S., Ejaz, Aslam, Howard, J. Harrison, Richtig, Erika, Ochsenreither, Sebastian, Reddy, Sunil A., Lowe, Michael C., Beasley, Georgia M., Gesierich, Anja, Bender, Armin, Gschnell, Martin, Dummer, Reinhard, Rivoire, Michel, Arance, Ana, Fenwick, Stephen William
Source: Annals of Surgical Oncology: An Oncology Journal for Surgeons; Aug2024, Vol. 31 Issue 8, p5340-5351, 12p
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). [ABSTRACT FROM AUTHOR]
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Database: Complementary Index
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ISSN:10689265
DOI:10.1245/s10434-024-15293-x
Published in:Annals of Surgical Oncology: An Oncology Journal for Surgeons
Language:English