Hepatic Arterial Infusion of Melphalan With Hepatic Perfusion in Treating Patients With Unresectable Liver Cancer

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically or cytologically confirmed hepatic malignancy
• * Unresectable disease
• * Disease predominantly in the parenchyma of the liver
• * One of the following primary tumor histologies:
• * Adenocarcinoma of gastrointestinal or other origin
• * Neuroendocrine tumor (except gastrinoma)
• * Primary hepatic malignancy (e.g., hepatocellular cancer or intra-hepatic cholangiocarcinoma)
• * Cutaneous or ocular melanoma (patients must have received prior regional melphalan therapy)
• * Hepatic metastases from colorectal tumors allowed provided patient has undergone prior first-line chemotherapy, including irinotecan or oxaliplatin
• Limited unresectable extrahepatic disease on preoperative radiological studies allowed if life-limiting component of progressive disease is in the liver
• * Limited extrahepatic disease includes, but is not limited to, the following:
• * Up to 4 pulmonary nodules each \< 1 cm in diameter
• * Retroperitoneal lymph nodes each \< 3 cm in diameter
• * Less than 10 skin or subcutaneous metastases each \< 1 cm in diameter
• * Asymptomatic bone metastases that have been or could be palliatively treated with external beam radiotherapy
• * Resectable solitary metastasis to any site
• Hormone receptor status:
• * Not specified
• PATIENT CHARACTERISTICS:
• Age
• 16 and over
• Sex
• Male or Female
• Menopausal status
• Not specified
• Performance status
• ECOG 0-2
• Life expectancy
• Not specified
• Hematopoietic
• Platelet count ≥ 75,000/mm\^3
• Hematocrit \> 27%
• Absolute neutrophil count ≥ 1,300/mm\^3
• Hepatic
• Bilirubin ≤ 2.0 mg/dL
• PT ≤ 2 seconds of upper limit of normal (ULN)
• AST and ALT ≤ 10 times ULN
• No Childs class B or C cirrhosis
• No portal hypertension by history, endoscopy, or radiologic studies
• Renal
• Creatinine ≤ 1.5 mg/dL OR
• Creatinine clearance \> 60 mL/min
• Cardiovascular
• No congestive heart failure
• LVEF ≥ 40%
• Pulmonary
• No chronic obstructive pulmonary disease
• FEV\_1 ≥ 30% of predicted
• DLCO ≥ 40% of predicted
• Immunologic
• No active infection
• No severe allergic reaction to iodine contrast agent that is not controlled by premedication with antihistamines or steroids
• No known hypersensitivity reaction to melphalan or heparin in the presence of a heparin induced thrombocytopenia (HIT) antibody
• Other
• Weight \> 35 kg
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No documented latex allergy
• No evidence of intracranial abnormalities which would lead to risk for bleeding with anticoagulation (e.g., stroke or active metastasis)
• No evidence of active ulcer disease
• PRIOR CONCURRENT THERAPY:
• Biologic therapy
• More than 1 month since prior biologic therapy and recovered
• Chemotherapy
• See Disease Characteristics
• More than 1 month since prior chemotherapy and recovered
• Endocrine therapy
• Premenopausal women (i.e., have had a period within the past 12 months) must be willing to undergo hormonal suppression during study treatment
• Radiotherapy
• See Disease Characteristics
• More than 1 month since prior radiotherapy and recovered
• Surgery
• No prior Whipple resection
• Other
• Prior intrahepatic perfusion (with or without arterial infusion with floxuridine) or peripheral hepatic perfusion allowed provided the patient had a radiographic partial response of 3 months' duration after therapy
• No concurrent immunosuppressive drugs
• No concurrent chronic anticoagulation therapy