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| Home > Publications database > Degradable Starch Microsphere Transarterial Chemoembolization as Salvage Therapy in Patients with Uveal Melanoma Liver Metastases. |
| Home > Publications database > Degradable Starch Microsphere Transarterial Chemoembolization as Salvage Therapy in Patients with Uveal Melanoma Liver Metastases. |
| Journal Article | DKFZ-2025-01105 |
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2025
Elsevier
Amsterdam [u.a.]
Abstract: To assess DSM-TACE retrospectively as salvage therapy in patients with unresectable uveal melanoma (UM) liver metastases and to identify prognostic factors for survival.Fifty-five patients (49.1% male, median age 65 years) who underwent a median of two (range 1-12) DSM-TACE treatments were included. Cox proportional hazard models for uni- and multivariate analyses (hazard ratio, 95% confidence interval [CI], p-value) and Kaplan-Meier analysis were performed to determine the median overall survival and time to progression (mOS/TTP; 95% CI). Response assessment was performed according to the RECIST 1.1 criteria.The median OS of the study cohort was 8.0 (95% CI: 6.7-9.3) months. Univariate analysis identified low lactate dehydrogenase (LDH <2x the upper level of normal) (0.26; 0.12-0.57, p<0.001), normal serum protein (0.32; 0.15-0.7, p=0.008), hepatic tumor burden ≤25% (0.39; 0.19-0.78, p=0.007), and monthly tumor growth rate (TGR) ≤ 20% before the first DSM-TACE (0.32; 0.14-0.7, p=0.005) as predictors of prolonged mOS. Multivariate analysis confirmed low LDH (mOS: 11.4 vs. 4.3 months, p=0.021) and low TGR (mOS: 9.9 vs. 6.4 months, p=0.005) as independent predictors. Median TTP was four months (95%CI: 3.1-5.7). The best response observed was PR in 13.6%, SD in 65.9%, and PD in 20.5%, with mOS of 25 (13.5-31.6), 8 (7.1-9.8), and 4.4 (2.1-20.4) months, respectively.DSM-TACE represents a salvage treatment option for UM patients with liver metastases that can help control the tumor. Lower pretreatment serum LDH levels and low TGR have been associated with prolonged mOS. However, direct comparison with alternative treatments is required.
Keyword(s): Degradable starch microspheres ; Liver metastases ; Transarterial chemoembolization ; Tumor growth rate ; Uveal melanoma
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