Long–Term Oncologic Outcomes After Isolated Limb Infusion for Locoregionally Metastatic Melanoma: An International Multicenter Analysis

Cutaneous melanoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

“…Such local treatments either require major surgery or experience using oncolytic viruses and should therefore be restricted to experienced centres. Since their efficacy data are less established, RT, electrochemotherapy, carbon dioxide (CO 2 ) laser or other intralesional therapy may also be proposed within clinical trials [V, D] [16,[45][46][47].…”

Isolated limb infusion: Institutional protocol and implementation

“…In efforts to decrease the occurrence of limb toxicity, US institutions administer a decreased dose of melphalan through calculation correction using IBW. AUS centers do not routinely make this correction, citing lower response rates without a significant decrease in limb toxicity 29,30 . Drug administration and circulation time may also differ.…”

“…With the full dose in the circuit, centers may perform either 15 or 30 minutes of circulation through the limb. This is one factor which leads to differences in duration of limb ischemia, where most report an ischemia time of less than 60 minutes, the interquartile range of tourniquet time has been reported to be 44 to 67 minutes in duration 29 …”

“…In the US, a similar multicenter study of 162 melanoma patients reported ORR of 64% and CR of 31% 15 . Most recently a multicenter, multinational study by Miura et al 44 evaluated 687 patients diagnosed with stage IIIB or IIIC melanoma treated with a first‐time ILI. These authors reported ORR of 64%, CR of 29%, with a median OS of 38 months over a median 47‐month follow‐up.…”

Let’s Not Forget About Regional Therapy for the Treatment of Locally Advanced Extremity Melanoma

“…In this issue of Annals of Surgical Oncology, Miura et al 5 present a large multicenter (including nine centers in the USA and Australia) retrospective experience of ILI in patients with stage IIIB/IIIC melanoma and extremity ITM. The study includes 687 patients with long-term follow-up undergoing first-time ILI with melphalan and actinomycin D, reporting a complete response (CR) rate of 28.9% with an overall response (OR) rate of 64.1%.…”