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Isolating the liver's circulation with catheters and balloons so that high-dose melphalan can be pumped through it and filtered out before it reaches the rest of the body; approved in 2023 for eye melanoma that has spread to the liver.
PHP (Delcath Hepzato/CHEMOSAT) uses a double-balloon catheter in the inferior vena cava to capture hepatic venous outflow, which is passed through activated-carbon filters before return, while melphalan 3 mg/kg is infused into the hepatic artery for 30 minutes. FOCUS trial (2023): 36% response and 74% disease control in uveal melanoma liver metastases with median PFS ~9 months; FDA approval August 2023 (Hepzato Kit, with REMS for myelosuppression and haemorrhage). CE-marked since 2012 in Europe, also used for cholangiocarcinoma and neuroendocrine liver metastases. It joins hepatic arterial infusion pumps (FUDR for colorectal liver metastases, MSK), TACE and radioembolisation among liver-directed therapies.
Regional isolation and extracorporeal filtration allow hepatic melphalan exposure roughly ten-fold higher than systemic tolerance, exploiting the liver-dominant metastatic pattern of uveal melanoma.
The myeloma chemotherapy that is also the standard high-dose conditioning before autologous transplant, and, delivered directly into the liver's blood supply or the eye, treats uveal melanoma metastases and retinoblastoma.
Query for this technology: (TITLE:"Percutaneous hepatic perfusion" OR ABSTRACT:"Percutaneous hepatic perfusion" OR TITLE:"chemosaturation" OR ABSTRACT:"chemosaturation") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Percutaneous hepatic perfusion (chemosaturation), not a curated reading list.
Shares Efficacy and Safety of the Melphalan/Hepatic Delivery System in Patients with Unresectable Metastatic Uveal Melanoma: Results from an Open-Label, Single-Arm, Multicenter Phase 3 Study, FOCUS, Uveal melanoma.
Shares An Open-Label Expanded Access Study of the Melphalan/Hepatic Delivery System (HDS) in Patients With Hepatic Dominant Ocular Melanoma, FOCUS, Uveal melanoma.
Shares Liver-directed therapy (TACE, TARE, HAI, ablation), Transarterial chemoembolisation (TACE), Neuroendocrine tumours.
Shares Liver-directed therapy (TACE, TARE, HAI, ablation), Transarterial chemoembolisation (TACE), Neuroendocrine tumours.
Shares Isolated limb perfusion and infusion, Liver-directed therapy (TACE, TARE, HAI, ablation).
Shares Isolated limb perfusion and infusion, Melphalan (including hepatic delivery system).
Shares Radioembolisation (TARE / SIRT, yttrium-90), Transarterial chemoembolisation (TACE).
Shares FOCUS, Tebentafusp.