Percutaneous hepatic perfusion with melphalan for metastatic uveal melanoma: mounting evidence and future perspectives

Tong, T.M.L. (2024)

Doctoral Thesis

Metastatic uveal melanoma (UM) represents a formidable challenge in oncology, characterized by limited treatment options and a poor prognosis. After successful treatment for the primary tumor, up to 50% of patients will develop metastases, mainly to the liver. Percutaneous hepatic perfusion with Melphalan (M-PHP) is a minimally invasive treatment option for patients with liver-dominant metastatic disease and is discussed in this thesis. Firstly, part I provides an overview of the outcomes of UM patients diagnosed in the Netherlands over a period of thirty years (1989 – 2019). In part II, the results of M-PHP in three European centers are presented. Furthermore we describe a prospective analysis on the quality of life of patients who underwent M-PHP for metastatic UM. In the last part of the thesis the ongoing CHOPIN trial is introduced. In this trial a novel combination of M-PHP with systemic immunotherapy (ipilimumab and nivolumab) is applied. The results of the phase Ib part of the CHOPIN study are presented, showing that a combination of M-PHP with ipilimumab at 1mg/kg and nivolumab at 3mg/kg is safe and feasible in patients with hepatic metastases from UM.

• Advanced uveal melanoma
• Liver metastases
• Percutaneous hepatic perfusion
• Melphalan
• Immunotherapy

• All authors: Tong, T.M.L.
• Supervisor: Blank, C.U.
• Co-supervisor: Burgmans, M.C.; Kapiteijn, H.W.
• Committee: Hage, J.A. van der; Luyten, G.P.M.; Meijerink, M.R.; Sitsen, M.E.; Bol, K.
• Qualification: Doctor (dr.)
• Awarding Institution: Leiden University Medical Center (LUMC), Leiden University
• Date: 2024-11-12
• ISBN (print): 9789465065991