Factors Associated with Improved Overall Survival for Patients Undergoing Embolization of Metastatic Melanoma

Monday, March 6, 2023

3:18 PM – 3:27 PM

Location: Phoenix Convention Center, 225AB

Presenting Author(s)

Leila Haghani, MD, MPH

Postdoc Fellow
UMass Chan Medical School, Interventional Radiology

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

Chenyang Zhan, MD, PhD

Assistant Attending
Memorial Sloan Kettering Cancer Center
HY

Hooman Yarmohammadi, MD

Associate Attending
Memorial Sloan-Kettering Cancer Center
EZ

Etay Ziv, MD PhD

Associate Attending
Memorial Sloan Kettering Cancer Center
Francois H. Cornelis, MD, PhD

Professor of Radiology
MSKCC, Weill Cornell Medical College
AG

Adrian Gonzalez Aguirre, MD

IR surgery
Interventional Radiology Division
AM

Amgad M. Moussa, MD

Attending
Memorial Sloan Kettering Cancer Center
ES

Ernesto Santos, MD

Professor
MSKCC
AS

Alexander Shoushtari, MD

Assistant Attending
Memorial Sloan Kettering Cancer Center
JE

Joseph P. Erinjeri, MD PhD

Attending
Memorial Sloan Kettering Cancer Center

Disclosure(s):

Leila Haghani, MD, MPH: No financial relationships to disclose

Etay Ziv, MD PhD: Ethicon J&J: Research Grant Recipient (Ongoing); Novartis Pharmaceuticals Corporation: Research Grant Recipient (Ongoing)

Francois H. Cornelis, MD, PhD: General Electric: Speaking and Teaching (Ongoing); Varian: Speaking and Teaching (Ongoing)

Purpose: To determine the factors which predict overall survival (OS) of metastatic melanoma patients undergoing transarterial embolization.

Materials and Methods: This single-center retrospective study included 65 patients with metastatic melanoma to the liver, who received transarterial embolization (TAE) and immunotherapy from 9/2009 to 1/2022. Clinical information including demographics and tumor characteristics, treatment processes, date of death, and date of last clinical follow up were reviewed. Kaplan Meier analysis was performed using the log-rank test and Cox proportional hazard for univariate and multivariate survival analysis, respectively.

Results: The median follow-up period after the first embolization was 9 months (range 0-75). The median OS from the first TAE was 10.1 months (95% CI, 7.2 - 14.4). The 1, 2 and 3 year survival rates from first embolization were 43%, 29%, and 14%, respectively. There was no significant difference in median OS for male vs female (8.3 vs 12.3 months, p< 0.7), type of melanoma (uveal, cutaneous, and other, 9.8 vs 6.5 vs 12.5 months, p< 0.5), or presence of extrahepatic disease (11.4 vs 10.1 months, p< 0.4). Patients who were < 25 years of age had significantly worse overall survival (3.6 vs 10.4 months, p< 0.04). Tumor size < 3cm trended toward but was not a significant predictor of survival (14.4 vs 6.9 months, p< 0.1). Having 3 or less tumors was a significant predictor of improved overall survival (24.4 vs 8.2, p< 0.01). Immunotherapy after embolization was associated improved median OS (14.2 vs 4.5, p< 0.001) while immunotherapy prior to embolization was not (10.3 vs 10.3 months, p< 0.3). Under multivariate analysis, the only independent predictors of improved OS were immunotherapy after embolization (HR 0.2, CI 0.11-0.38, p< 0.001) and having 3 or less tumors (HR 0.47, CI 0.27-0.83, p< 0.009).

Conclusion: For patient undergoing embolization for melanoma metastases to the liver, immunotherapy after embolization and having 3 or less tumors was associated with improved OS.