Transarterial Chemoembolization for the Treatment of Uveal Melanoma With Liver Metastases

Exclusion Criteria

• •Less than 18 years of age
• •Previous liver-directed treatments including immunoembolization, chemoembolization, radioembolization, hepatic arterial perfusion, or drug-eluting beads
• •Presence of life-limiting extrahepatic metastasis that requires systemic treatment within 3 months. However, radiation treatment of extrahepatic metastases such as bone, lymph nodes or subcutaneous metastases will be permitted while the patient is on study. Zometa or X-Geva to treat bone metastases will also be permitted. Immune check-point inhibitors while on study will NOT be permitted
• •Portal vein occlusion, or inadequate collateral portal venous flow, as determined by MRI
• •Known active viral or autoimmune hepatitis requiring treatments with serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) equal or greater than 5 times normal
• •Presence of uncontrolled hypertension or congestive heart failure, or acute myocardial infarction within 6 months of entry
• •Presence of any other medical conditions that imply a survival of less than six months
• •Uncontrolled severe bleeding tendency or active gastrointestinal (GI) bleeding due to varices or main portal vein occlusion. Abnormal coagulation test must be corrected prior to the procedure
• •History of life-threatening allergic reaction to iodinated contrast or BCNU despite pre-treatment with steroids
• •Pregnant and/or breastfeeding women
• •Presence of known untreated brain metastases. If patients have had previous treatment for brain metastasis, an MRI or CT of the brain must confirm the stabilization of the brain metastasis for more than 4 weeks
• •Biliary obstruction, biliary stent, or prior biliary surgery including sphincterotomy but excluding cholecystectomy