Percutaneous hepatic perfusion (chemosaturation)
Isolating the liver's circulation with catheters and balloons so that high-dose melphalan can be pumped through it and filtered out before it reaches the rest of the body; approved in 2023 for eye melanoma that has spread to the liver.
PHP (Delcath Hepzato/CHEMOSAT) uses a double-balloon catheter in the inferior vena cava to capture hepatic venous outflow, which is passed through activated-carbon filters before return, while melphalan 3 mg/kg is infused into the hepatic artery for 30 minutes. FOCUS trial (2023): 36% response and 74% disease control in uveal melanoma liver metastases with median PFS ~9 months; FDA approval August 2023 (Hepzato Kit, with REMS for myelosuppression and haemorrhage). CE-marked since 2012 in Europe, also used for cholangiocarcinoma and neuroendocrine liver metastases. It joins hepatic arterial infusion pumps (FUDR for colorectal liver metastases, MSK), TACE and radioembolisation among liver-directed therapies.
How it works
Regional isolation and extracorporeal filtration allow hepatic melphalan exposure roughly ten-fold higher than systemic tolerance, exploiting the liver-dominant metastatic pattern of uveal melanoma.
- Randomised/pivotal evidence in a disease with few options
- Repeatable (up to 6 cycles)
- Treats the whole liver, including occult disease
- Myelosuppression despite filtration; bleeding, hepatic injury
- Requires specialised interventional radiology and anaesthesia
- Liver-only benefit; extrahepatic disease progresses
Latest papers
topQuery for this technology: (TITLE:"Percutaneous hepatic perfusion" OR ABSTRACT:"Percutaneous hepatic perfusion" OR TITLE:"chemosaturation" OR ABSTRACT:"chemosaturation") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Percutaneous hepatic perfusion (chemosaturation), not a curated reading list.
Pages like this
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