Response and Toxicity of Repeated Isolated Limb Perfusion (re-ILP) for Patients With In-Transit Metastases of Malignant Melanoma

Overview

Journal Ann Surg Oncol

Publisher Springer

Specialty Oncology

Date 2019 Jan 9

PMID 30617871

Citations 5

Authors

Valerio Belgrano

Jessica Pettersson

Jonas A Nilsson

Jan Mattsson

Dimitrios Katsarelias

Roger Olofsson Bagge

Affiliations

Soon will be listed here.

Abstract

Background: Isolated limb perfusion (ILP) is a safe and well-established treatment for in-transit metastases of melanoma. In case of relapse or disease progression, ILP can be repeated (re-ILP). This study aimed retrospectively to analyze a large consecutive series of re-ILP and compare clinical outcomes with first-time ILP.

Method: Between 2001 and 2015, 290 consecutive patients underwent 380 ILPs. Of these, 90 were re-ILPs including 68 second ILPs, 16 third ILPs, 4 fourth ILPs, and two fifth ILPs. The study evaluated response (using World Health Organization [WHO] criteria), local toxicity (using the Wieberdink scale), and complications (using Clavien-Dindo).

Results: The results were compared between the first ILP, the second ILP, and the third to fifth ILP. The overall response rate was respectively 83%, 80% and 68%, with a complete response (CR) rate of 60%, 41%, and 59%. In the re-ILP group, the patients with a CR after the first ILP had a 65% CR rate after the second ILP compared with 8% for the patients without a CR (p = 0.001). The risk for local toxicity or complications was not increased after re-ILP. The median overall survival periods were respectively 34, 41, and 93 months (p = 0.02).

Conclusion: As a therapeutic option, ILP can be repeated safely for in-transit metastases of melanoma, achieving similar high response rates without increasing complications or toxicity. Re-ILP is mainly indicated for patients who already had a CR after the first ILP, whereas other treatment options should be considered for primary non-responders.

Citing Articles

Intralesional and Infusional Updates for Metastatic Melanoma.

Dugan M, Shannon A, DePalo D, Perez M, Zager J Cancers (Basel). 2024; 16(11).

PMID: 38893078 PMC: 11171204. DOI: 10.3390/cancers16111957.

Isolated Limb Perfusion and Immunotherapy in the Treatment of In-Transit Melanoma Metastases: Is It a Real Synergy?.

Rastrelli M, Russano F, Cavallin F, Del Fiore P, Pacilli C, Di Prata C J Pers Med. 2024; 14(5).

PMID: 38793023 PMC: 11122383. DOI: 10.3390/jpm14050442.

Plant-Derived Terpenoids: A Promising Tool in the Fight against Melanoma.

Klos P, Chlubek D Cancers (Basel). 2022; 14(3).

PMID: 35158770 PMC: 8833325. DOI: 10.3390/cancers14030502.

Role of Isolated Limb Perfusion in the Era of Targeted Therapies and Immunotherapy in Melanoma. A Systematic Review of The Literature.

Sevilla-Ortega L, Ferrandiz-Pulido L, Palazon-Carrion N, Alamo de la Gala M, de Toro-Salas R, Garnacho-Montero J Cancers (Basel). 2021; 13(21).

PMID: 34771649 PMC: 8583108. DOI: 10.3390/cancers13215485.

In-transit metastatic cutaneous melanoma: current management and future directions.

Patel A, Carr M, Sun J, Zager J Clin Exp Metastasis. 2021; 39(1):201-211.

PMID: 33999365 DOI: 10.1007/s10585-021-10100-3.

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