SIR 2024
Interventional Oncology
Jason Ni, MD
Resident Physician
UCLA
Financial relationships: Full list of relationships is listed on the CME information page.
Siddharth Padia, MD
Professor
David Geffen School of Medicine at UCLA
Financial relationships: Full list of relationships is listed on the CME information page.
Matthew Quirk
Disclosure information not submitted.
Hepatic metastases from uveal melanoma portends a poor prognosis, and systemic treatment options are limited. We aim to assess the safety and efficacy of Yttrium-90 radioembolization as a treatment option for these patients.
Materials and methods:
An IRB-approved retrospective study of patients with liver metastases from uveal melanoma treated by radioembolization from 2017-2023 was performed. Age, sex, date of diagnosis and metastasis, initial imaging characteristics, systemic and concomitant therapies, treatment dosage, imaging response, treatment related toxicities, and survival were collected and reviewed. Imaging response was based on standard RECIST criteria as well as degree of complete necrosis of the index tumor.
Results:
25 patients (9 males, 11 females) with a mean age at metastatic diagnosis of 61 ± 5 years (95% CI, range 30-78) underwent a total of 52 glass Y90 radioembolization procedures (32 segmentectomies > 200 Gy, 20 lobar treatments 80-120 Gy). Average index tumor size was 4.1 ±1.0 cm (range 0.9-20). For the index tumor, complete necrosis (n=32) or partial necrosis (n=17) was achieved in 49/52 (94%) treatments. There was a significant difference in complete index tumor necrosis in the segmentectomy group compared to the lobar group (p < 0.05). RECIST disease control rate was 84% (21/25). Median overall survival was 18.9 ±5.4 months (95% CI, range 1.6-55.5) and progression free survival was 8.1 ±4.4 months (95% CI, range 0-50.4). 64% (13/25) of the patients died at the end of the study date with 76% (19/25) surviving at 1 year. Most common cause of death was tumor progression (12/13). 12 patients experienced mild transient side effects including: fatigue, pain, nausea, and vomiting and 11 experienced transient laboratory abnormalities including one patient with grade 4 lymphopenia.
Conclusion:
Y90 radioembolization is an effective and safe treatment option for patients with hepatic metastatic uveal melanoma.