Predictors of Overall and Progression-Free Survival in Patients with Ocular Melanoma Metastatic to the Liver Undergoing Y90 Radioembolization

Abstract

Purpose

To investigate predictors of overall survival (OS) and progression-free survival (PFS) in patients with ocular melanoma metastatic to the liver undergoing yttrium-90 (Y90) radioembolization, including the effect of concurrent immunotherapy.

Methods

An IRB-approved retrospective review of 24 patients with ocular melanoma metastatic to the liver who underwent Y-90 treatment between June 2003 and January 2018 was performed. Data regarding patients’ performance status at the time of Y90, intra-/extrahepatic tumor burden, and treatment response were evaluated. RECIST was used to determine objective tumor response. Kaplan–Meier analysis was used to calculate OS and PFS from the first Y90 therapy. Log-rank analysis was used to determine predictors of prolonged OS and PFS.

Results

Median OS from primary diagnosis and diagnosis of liver metastases was 66 months (mo) and 26.3 mo, respectively. Median OS for those who received immunotherapy within 3 months of undergoing Y90 was prolonged at 26.0 mo versus 9.5 mo for others (p = 0.014). Median OS for patients with an ECOG performance status of 0 was prolonged at 26 mo versus 5.5 mo for others (p = 0.003). Median hepatic PFS was prolonged in patients treated with Y-90 on concurrent immunotherapy at 10.3 mo versus 2.7 mo for TARE only (p = 0.002). Patients with an ECOG performance status of 0 had prolonged PFS (p = 0.002).

Conclusions

Concurrent immunotherapy and an ECOG performance status of 0 at the time of Y90 therapy appear to be predictors of prolonged OS and PFS in patients with ocular melanoma metastatic to the liver.

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Funding

This study was not supported by any funding.

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Authors

Contributions

Nima Kokabi, preceptor, conceived and designed the analysis. Alexa Levey and Mohammad Elsayed collected the data and performed the analysis. Alexa Levey wrote the paper. All authors discussed the results and contributed to the final manuscript.

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Correspondence to Nima Kokabi.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. For this study, no formal consent is required. The study was approved by IRB.

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This study has obtained IRB approval (indicate the relevant board) and the need for informed consent was waived. For this type of study, consent for publication is not required.

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Levey, A.O., Elsayed, M., Lawson, D.H. et al. Predictors of Overall and Progression-Free Survival in Patients with Ocular Melanoma Metastatic to the Liver Undergoing Y90 Radioembolization. Cardiovasc Intervent Radiol 43, 254–263 (2020). https://doi.org/10.1007/s00270-019-02366-8

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Keywords

  • Uveal melanoma
  • Ocular melanoma
  • Liver metastasis
  • Immunotherapy
  • Radioembolization