Halt Growth of Liver Tumors From Uveal Melanoma With Closure of Liver Artery Following Injection of GM-CSF
| Status: | Completed |
|---|---|
| Conditions: | Skin Cancer, Liver Cancer, Cancer |
| Therapuetic Areas: | Oncology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | October 2004 |
| End Date: | June 2012 |
Immuno-embolization of Hepatic Artery With Granulocyte-macrophage Colony Stimulating Factor (GM-CSF)
Patients with uveal melanoma metastatic to the liver will be treated with embolization of
the hepatic artery every 4 weeks. GM-CSF (granulocyte-macrophage colony simulating factor)
or normal saline will be injected into one of the liver arteries with an oily contrast dye,
Ethiodol. This is followed by blockage of the artery with small pieces of gelatin sponge
(embolization). It is hoped with this novel approach that:
- tumor cells will die due to a loss of their blood supply,
- local inflammatory reactions induced by GM-CSF will kill remaining tumor cells, and
- a systemic immune response against tumor cells may develop.
the hepatic artery every 4 weeks. GM-CSF (granulocyte-macrophage colony simulating factor)
or normal saline will be injected into one of the liver arteries with an oily contrast dye,
Ethiodol. This is followed by blockage of the artery with small pieces of gelatin sponge
(embolization). It is hoped with this novel approach that:
- tumor cells will die due to a loss of their blood supply,
- local inflammatory reactions induced by GM-CSF will kill remaining tumor cells, and
- a systemic immune response against tumor cells may develop.
Patients with uveal melanoma metastatic to the liver will be treated with embolization of
the hepatic artery every 4 weeks. GM-CSF (granulocyte-macrophage colony simulating factor)
or normal saline will be injected into one of the liver arteries with an oily contrast dye,
Ethiodol. This is followed by blockage of the artery with small pieces of gelatin sponge
(embolization).
the hepatic artery every 4 weeks. GM-CSF (granulocyte-macrophage colony simulating factor)
or normal saline will be injected into one of the liver arteries with an oily contrast dye,
Ethiodol. This is followed by blockage of the artery with small pieces of gelatin sponge
(embolization).
Inclusion Criteria:
- Metastatic uveal melanoma in the liver with histological confirmation
- Ability/willingness to give informed consent
- ECOG performance status of 0 or 1
- Adequate renal, liver and bone marrow function
Exclusion Criteria:
- Solitary liver metastasis that is amenable to surgical removal
- Presence of symptomatic liver failure including ascites and hepatic encephalopathy
- Presence of extra-hepatic metastases
- Untreated brain metastases
- Uncontrolled hypertension or congestive heart failure or acute myocardial infarction
within 6 months of entry
- Presence of any other medical complication that imply survival of less than six
months
- Uncontrolled sever bleeding tendency or active GI bleeding
- Significant allergic reaction to contrast dye or GM-CSF
- Immunosuppressive treatments such as systemic steroids, radiation to pelvis or
systemic chemotherapy within 4 weeks
- Previous embolization of the hepatic artery or intrahepatic arterial chemotherapy of
liver metastasis
- Active hepatitis with serum glutamic oxaloacetic transaminase (SGOT) and serum
glutamic pyruvic transaminase (SGPT) greater than 5 x normal
- HIV infection positive by ELISA
- Pregnancy or breast feeding women
- Biliary obstruction, biliary stent or prior biliary surgery except cholecystectomy
- Significant arteriovenous shunt identified on angiography of the hepatic artery
- Occlusion of main portal vein or inadequate collateral flow around an occluded portal
vein
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