Does Locoregional Chemotherapy Still Matter in the Treatment of Advanced Pelvic Melanoma?

• Published in: International journal of molecular sciences Vol. 18; no. 11; p. 2382
• Main Authors: Guadagni, Stefano, Fiorentini, Giammaria, Clementi, Marco, Palumbo, Giancarlo, Palumbo, Paola, Chiominto, Alessandro, Baldoni, Stefano, Masedu, Francesco, Valenti, Marco, Tommaso, Ambra Di, Fabi, Bianca, Aliberti, Camillo, Sarti, Donatella, Guadagni, Veronica, Pellegrini, Cristina
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 09-11-2017; MDPI
• Subjects: Aged; Antineoplastic Agents, Alkylating - therapeutic use; BRAF; Cancer therapies; Chemotherapy; Chemotherapy, Cancer, Regional Perfusion - methods; Cohort Studies; Drug screening; Female; Humans; Hypoxia; Immunotherapy; Male; Melanoma; Melanoma - drug therapy; Melanoma - pathology; Melphalan; Melphalan - therapeutic use; Metastases; Metastasis; Middle Aged; Mutation; Neoplasm Metastasis; Neoplasm Recurrence, Local - drug therapy; Neoplasm Staging; Patients; Pelvic Neoplasms - drug therapy; Pelvic Neoplasms - pathology; pelvic perfusion; Pelvis; Pelvis - pathology; Perfusion; Proto-Oncogene Proteins B-raf - genetics; Retrospective Studies; stopflow; Survival Analysis; hypoxia; melanoma; BRAF; pelvic perfusion; stopflow; Melphalan
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms18112382

Pelvic Melanoma relapse occurs in 15% of patients with loco regional metastases, and 25% of cases do not respond to new target-therapy and/or immunotherapy. Melphalan hypoxic pelvic perfusion may, therefore, be an option for these non-responsive patients. Overall median survival time (MST), stratified for variables, including BRAF V600E mutation and eligibility for treatments with new immunotherapy drugs, was retrospectively assessed in 41 patients with pelvic melanoma loco regional metastases. They had received a total of 175 treatments with Melphalan hypoxic perfusion and cytoreductive excision. Among the 41 patients, 22 (53.7%) patients exhibited a wild-type
genotype, 11 of which were not eligible for immunotherapy. The first treatment resulted in a 97.5% response-rate in the full cohort and a 100% response-rate in the 22 wild-type
patients. MST was 18 months in the full sample, 20 months for the 22 wild-type
patients and 21 months for the 11 wild-type
patients not eligible for immunotherapy. Melphalan hypoxic perfusion is a potentially effective treatment for patients with pelvic melanoma loco regional metastases that requires confirmation in a larger multicenter study.