Eye cancer known as uveal melanoma most often spreads to the liver; a new treatment improves chances of response while limiting side effects and toxicity
SCOTTSDALE, Ariz. — Sept. 24, 2024 — HonorHealth Research Institute is one of the few sites in the nation — and the first in Arizona — to offer a new treatment for cancer that has spread to the liver as a result of a rare eye cancer called uveal melanoma.
Like other melanomas, uveal melanoma originates in pigmentation cells, in this case, the cells in the back of the eye. When uveal melanoma metastasizes or spreads, it is most often found in the liver. Metastatic uveal melanoma historically has had few treatment options and poor overall outcomes.
The treatment, known as the HEPZATO KIT, relies on a proven chemotherapy developed in the 1960s but whose use in patients is limited due to side effects. HEPZATO limits these side effects and toxicity by circulating the chemotherapy only to the liver, where the cancer resides. Following treatment, the chemotherapy is filtered out of the liver and cannot cause side effects in other parts of the body.
“One of the challenges of treating uveal melanoma is that it often spreads to the liver, which until now has presented few good options,” said Justin Moser, M.D., an associate clinical investigator in the Research Institute’s Oncology Research Division, and a recognized specialist in treating uveal melanoma.
HEPZATO treatment consists of isolating the liver blood supply, a 30-minute infusion of high-dose melphalan that saturates the liver, and a 30-minute washout period that uses special filters to remove more than 80% of the medication before returning the blood to the patient, thereby limiting the rest of the body’s exposure to the chemotherapy.
Chemo developed in the 1960s
Melphalan, approved by the FDA in 1964, causes rapid and irreversible DNA damage that results in cancer cell death. In initial tests, more than one in three patients responded to the HEPZATO treatment.
HEPZATO relies on a specially trained team that includes: an interventional radiologist who leads and performs the vascular intervention procedure; a perfusionist to establish, monitor and control the blood isolation device; and an anesthesiologist to manage sedation, analgesic, respiratory and cardiovascular support. The Institute’s team also works closely with the hospital pharmacy, blood bank and intensive care unit.
Because of the limited systemic exposure of chemotherapy, patients are often able to be discharged from the hospital the day after treatment. Patients receive up to six treatments of HEPZATO once every 6-8 weeks.
The first patient in Arizona was treated at the Institute with HEPZATO in late July, supervised in part by Jason Low, M.D., an interventional radiology specialist.
"It's been an incredible honor to be able to participate in this new cutting-edge cancer treatment and a joy to be able to positively impact patients' lives by giving them access to the best therapeutic options available,” said Dr. Low. “I am really lucky to have such an amazing team here at HonorHealth that allows us to provide such great care. We are truly invigorating health care."