In a nutshell
The authors evaluated the effectiveness of administering melphalan (Alkeran) and TNF (a protein involved in inflammation process) by ‘isolated limb perfusion (ILP)’- a technique to apply drugs at the sites of tumors in melanoma. They found out that ILP with melphalan and TNF was effective in relieving pain in advanced in-transit melanoma.
Some background
ILP is a highly sophisticated surgical technique where high doses of anti-cancer drugs, such as chemotherapy, can be given directly into the melanoma-affected limb (leg or arm). The affected limb is isolated from the blood circulation using a tight band. This way, the vital organs of the body are not exposed to the high dose of chemotherapy. This technique is particularly useful for melanoma that has spread (metastasized) to the adjacent lymph nodes (tiny, bean-shaped organs which help fight infections) in the skin. This is called in-transit melanoma.
Melphalan has been established as an effective therapy in melanoma. It can be combined with TNF (tumor necrosis factor—a protein), which plays a major role in controlling pain.
Methods & findings
The authors aimed to assess the outcome of in-transit melanoma patients when treated by ILP with melphalan and TNF.
A total of 103 ILPs were performed. Out of these, 1 was in the upper limbs (arms, hands, and shoulders) and 102 were in lower limbs (legs, feet, thighs, and hips). Response was measured in 93 patients.
The overall response rate (complete or partial disappearance of tumors) was 81.8% in in-transit melanoma. 45.2% saw a complete response. 97% of limbs were saved. The average progression-free survival (time from treatment until the disease progresses) was 11 months.
Overall, 5.4% of patients suffered from severe treatment-related side effects in the affected limb.
The bottom line
The authors concluded that ILP with melphalan and TNF was a safe and effective treatment for in-transit melanoma.
Published By :
Annals of Surgical Oncology
Date :
Sep 08, 2015
