Imaged Guided Transarterial Chemoembolization with Drug-Eluting Beads Loaded with Doxorubicin (DEBDOX) for Hepatic Metastases from Melanoma: Early Outcomes from a Multi-Institutional Registry

Abstract

Patients with unresectable hepatic metastases from melanoma present a difficult clinical challenge due to lack of locoregional control and poor response to systemic chemotherapy. This study aims to examine the early outcomes of the novel treatment of unresectable hepatic metastases from melanoma with drug-eluting beads loaded with doxorubicin (DEBDOX) delivered via image guided transarterial chemoembolization. A multicenter prospective open registry of hepatic-directed therapy with drug-eluting beads was reviewed. Six patients underwent 12 DEBDOX treatments for liver-predominant, unresectable metastases from melanoma. Six adverse events (grade 1 or 2) were exhibited in three patients and were most commonly emesis, nausea, and pain. Over a median follow-up of 12 months (range: 6-17), response rates of 100 per cent, 83 per cent, and 60 per cent were observed at 3, 6, and 9 months respectively, based on standardized computed tomographic criteria. A median survival of 12.3 months after initial DEBDOX treatment was observed. Initial results for liver-directed therapy of hepatic-dominant metastatic disease from melanoma with DEBDOX demonstrate that this is a safe and well-tolerated treatment option with favorable response rates and survival characteristics at this point in follow-up. Salvage therapy with DEBDOX should be considered in the multidisciplinary therapy for this clinical dilemma.

Hepatectomy after hepatic arterial therapy with either yttrium-90 or drug-eluting bead chemotherapy: is it safe?

“…Pre‐HAT patients underwent treatment with either yttrium‐90 radioembolization using SIR‐Spheres (SIRTex Medical Ltd, Sydney, Australia) or DEB therapy using the LC Bead (Biocompatibles UK, Ltd, Surrey, United Kingdom) loaded with either doxorubicin or irinotecan. Methods for HAT delivery have been previously reported 2,5,6 …”

Chemoembolization Beyond Hepatocellular Carcinoma: What Tumors Can We Treat and When?

“…DEB-TACE utilizing DEBDOX has also been evaluated in this patient population. 190 The largest experience included 19 patients with bulky UM liver metastases who were initially treated with two separate lobar treatments of DEBDOX-TACE, with subsequent transarterial treatments consisting of BCNU-TACE. 191 The ORR was 16% and approximately half of patients demonstrated stable disease.…”

Hepatic Arterial Therapy with Drug-Eluting Beads in the Management of Metastatic Pancreatic Carcinoma to the Liver: A Multi-Institutional Registry

“…Defining the amount of liver disease was integral to defining both the number of treatments and the type of catheter position and therapy that would be performed. For finite numbers of lesions, defined as less than four lesions, a treatment cycle was planned for a minimum of two dosing schedules of at least 100 mg of DEBDOX to 150 mg of DEBDOX [ 16 , 17 ] loaded in two bead vials or 100 mg DEBIRI [ 18 ] loaded in one vial. Bead size of 100 to 300 microns was recommended.…”