Uveal mealnoma: Immunoembolization – pro
Uveal melanoma is a very difficult disease to treat and it has a poor prognosis. An approach developed at Jefferson University in Philadelphia has been termed Immunoembolization(IE) of the hepatic artery and it has been used to treat primary liver cancer (hepatoma), as well as liver metastases from uveal melanoma, neuroendocrine tumors, colorectal cancer and leiomyosarcoma. The rationale for this approach is that liver tumors receive their blood supply mainly from the hepatic artery, while normal liver is supplied with blood from the portal vein. The cytokines that have been used for immunoembolization at Thomas Jefferson University Hospital include GM-CSF, interleukin 2 (IL-2) and interferon alpha (IFN-alpha).
A phase II study by Yamamoto in 2009 cpmpared chemoembolization(CE) and IE. It concluded that treatment with high-dose IE prolonged survival of patients with uveal melanoma who received embolization of hepatic metastases and possibly delayed progression of extrahepatic metastases. This is a very interesting result but true comparative studies with more patients are needed before this coclusion will be widely accepted.
Yamamoto A, Chervoneva I, Sullivan KL, Eschelman DJ, Gonsalves CF, Mastrangelo MJ, Berd D, Shields JA, Shields CL, Terai M, Sato T.
High-dose immunoembolization: survival benefit in patients with hepatic metastases from uveal melanoma. Radiology. 2009 Jul;252(1):290-8.
Takami Sato, David J. Eschelman, Carin F. Gonsalves, Mizue Terai, Inna Chervoneva, Peter A. McCue, Jerry A. Shields, Carol L. Shields, Akira Yamamoto, David Berd, Michael J. Mastrangelo and Kevin L. Sullivan Immunoembolization of Malignant Liver Tumors, Including Uveal Melanoma, Using Granulocyte-Macrophage Colony-Stimulating Factor JCO November 20, 2008 vol. 26 no. 33 5436-5442
Carin F. Gonsalves et al, Radioembolization as Salvage Therapy for Hepatic Metastasis of Uveal Melanoma: A Single-Institution Experience
AJR February 2011 vol. 196 no. 2 468-473