Chemosaturation Percutaneous Hepatic Perfusion: A Systematic Review

Adv Ther. 2017 Jan;33(12):2122-2138. doi: 10.1007/s12325-016-0424-4. Epub 2016 Oct 31.

Abstract

The Hepatic CHEMOSAT® Delivery System is an innovative medical device for the treatment of patients with unresectable primary liver tumors or unresectable hepatic metastases from solid organ malignancies. This system is used to perform chemosaturation percutaneous hepatic perfusion (CS-PHP), a procedure in which a high dose of the chemotherapeutic agent melphalan is delivered directly to the liver while limiting systemic exposure. In a clinical trial program, CS-PHP with melphalan significantly improved hepatic progression-free survival in patients with unresectable hepatic metastases from ocular or cutaneous melanoma. Clinically meaningful hepatic responses were also observed in patients with hepatocellular carcinoma or neuroendocrine tumors. Furthermore, the results of published studies and case reports demonstrated that CS-PHP with melphalan resulted in favorable tumor response rates in a range of tumor histologies (ocular or cutaneous melanoma, colorectal cancer, and hepatobiliary tumors). Analyses of the safety profile of CS-PHP revealed that the most common adverse effects were hematologic events (thrombocytopenia, anemia, and neutropenia), which were clinically manageable. Taken together, these findings indicate that CS-PHP is a promising locoregional therapy for patients with primary and secondary liver tumors and has a acceptable safety profile.

Funding: Delcath Systems Inc., New York, NY, USA.

Keywords: Chemosaturation percutaneous hepatic perfusion; Hepatic metastases; Melphalan; Oncology; Primary liver tumors.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use*
  • Carcinoma, Hepatocellular / drug therapy*
  • Chemotherapy, Cancer, Regional Perfusion / instrumentation*
  • Colorectal Neoplasms / drug therapy*
  • Female
  • Humans
  • Liver Neoplasms / drug therapy*
  • Male
  • Melanoma / drug therapy*
  • Melanoma, Cutaneous Malignant
  • Melphalan / therapeutic use*
  • Middle Aged
  • Skin Neoplasms / drug therapy*

Substances

  • Antineoplastic Agents
  • Melphalan