Multicenter phase 3 trial of isolated hepatic perfusion with melphalan for isolated uveal melanoma liver metastases

About half of patients with metastatic uveal melanoma present with isolated liver metastasis. The median survival of these patients is 6-12 months. The phase 3 SCANDIUM trial in Sweden evaluated isolated hepatic perfusion (IHP) for previously untreated isolated uveal melanome liver metastases. Patients were randomized to one-time IHP or best alternative care (chemotherapy, immune checkpoint inhibitors, or local therapy other than IHP). The ORR was 40% versus 4,5% (p<0.0001) and median PFS was 7,4 months versus 3.3 months (p<0.0001). In the IHP group 11 patients had serious treatment-related adverse events, and there was one treatment-related death.