LC Bead Embolization Agent With Doxorubicin in the Treatment Liver Metastasis From Melanoma

Not Applicable

Completed

Brief Summary: The purpose of this study is to determine if LC beads loaded with Doxorubicin are a safe and effective treatment for melanoma that has spread to the liver.

Detailed Description: In this study, trans-arterial chemoembolization will be used to deliver LC beads loaded with Doxorubicin directly into liver tumors resulting from malignant melanoma.

Recruitment & Eligibility

Inclusion Criteria

Patients with unresectable, measurable disease defined as at least one lesion that can be accurately and serially measured per the modified RECIST and EASL criteria (2D/3D-EASL) or MRI (Extent of Necrosis)
Patients ≥ 18 years of age, > 35kg, of any race or sex, who have histological or radiological proof of melanoma to the liver
ECOG performance status < 3
Patient chooses to participate and has signed the informed consent document
Patients with unilobar disease who can be treated superselectively in a single session or patients with bilobar disease who can have both lobes able to be treated within 3 - 4 weeks in separate sessions
Patients with patent main portal vein
Ocular melanoma is allowed
Patients with clinically and radiologically stable brain metastasis from melanoma can be included
Patients with liver dominant disease (>50% overall tumor burden)
Prior systemic therapy for metastatic disease is allowed
Non-pregnant with an acceptable contraception in premenopausal women and fertile men
Hematological function: ANC ≥1.5 x 109/L, platelets ≥ 75 x 109/L, INR ≤1.3 (patients on therapeutic anticoagulants are not eligible)
Adequate renal function: Creatinine ≤2.0mg/dl and GFR >30
Adequate liver function: total bilirubin ≤ 2.5 mg/dl, ALT, AST ≤ 5 times ULN, albumin ≥ 2.5mg/dl
All toxic effects of prior therapy must have resolved to ≤ Grade 1 unless otherwise specified above

Exclusion Criteria

Women who are pregnant or breast feeding
Patients eligible for curative treatment such as resection or radiofrequency ablation
Active bacterial, viral or fungal infection within 72 hours of study entry
Previous or concurrent cancer that is distinct in primary site or histology from the cancer being evaluated in this study except cervical carcinoma in situ, treated basal cell carcinoma, superficial bladder tumors (TA, Tis & Ti) or any cancer curatively treated < 5 years prior to study entry
Contraindication to hepatic artery embolization procedures:
Severe peripheral vascular disease precluding catheterization
Large shunt as determined by the investigator (pretesting with TcMAA not required) at the time of first angiogram
Hepatofugal blood flow
Main portal vein occlusion (e.g. thrombus or tumor)
Recovery from major trauma including surgery within 4 weeks prior to administration of study treatment.
Allergy to contrast media that cannot be managed with standard care (e.g. steroids), making magnetic resonance imaging (MRI) or computed tomography (CT) contraindicated
Advanced liver disease (> 80% liver replacement)
Other significant medical or surgical condition, or any medication or treatment that would place the patient at undue risk and that would preclude the safe use of chemoembolization or would interfere with study participation
Any contraindication for doxorubicin administration:
WBC <3000 cells/mm3
Neutrophils <1500 cells/mm3
Deficient cardiac function defined as a LVEF of <50% normal

Arm && Interventions

Group	Intervention	Description
Transcatheter Arterial Chemoembolization	LC beads loaded with Doxorubicin	TACE using LC beads loaded with Doxorubicin

Primary Outcome Measures

Name	Time	Method
Incidence of Adverse Events	Date of surgery through 2 years post procedure or until patient death	Adverse events were collected from all 20 subjects.

Secondary Outcome Measures

Name	Time	Method
Percentage of Tumor Response	Percentage of tumor response assessed up to 1 year post treatment.	Progression is determined using Modified Response Evaluation Criteria in Solid Tumors (mRECIST). Progressive disease is defined as at least 20% increase in the sum of the longest target lesions, taking as reference the smallest sum longest diameter recorded since start of treatment OR appearance of one or more new lesions greater then 1cm in size. Percentage of tumor response will be assessed up to 1 year post treatment.

Locations (3): University of Louisville
🇺🇸
Louisville, Kentucky, United States
MD Anderson Cancer Center
🇺🇸
Houston, Texas, United States
Thomas Jefferson University
🇺🇸
Philadelphia, Pennsylvania, United States