More than 100,000 people in the United States are diagnosed with some form of melanoma every year. Although most melanomas are skin cancers, there are some that affect other parts of the body. One of these rarer forms of the disease is uveal melanoma, which affects the middle section of the eyeball (the uvea). This part of the eye contains the iris, the muscles around the iris and a thin layer of blood vessels.
In its more advanced stages, uveal melanoma can sometimes spread (or metastasize) from the eye to other parts of the body. Approved for use by the U.S. Food and Drug Administration in 2023, melphalan (HepzatoTM Kit) is a relatively new treatment option for patients with uveal melanoma that has spread to the liver. It works by delivering chemotherapy directly to liver tumors.
“This option has been shown in studies to decrease the size of the tumors in the liver and extend patients’ survival,” says Jonathan Kessler, M.D., chief of the Division of Interventional Radiology at City of Hope® Cancer Center Duarte.
This blog covers the basics on melphalan, including:
If you or a loved one has been diagnosed with a form of melanoma and would like a second opinion, call us 24/7 at 877-834-8941.
What Is Hepzato Kit?
Hepzato Kit is the brand name given to treatment for uveal cancer that has spread to the liver. It’s a unique way of delivering the chemotherapy medication called melphalan into the body and targeting it at the site of a tumor in the liver.
“It’s a way to deliver chemotherapy that is isolated to the liver, so we get the benefit of delivering the drug directly where it needs to go while lessening the systemic effects and side effects associated with traditional chemotherapy,” says Dr. Kessler, who administers Hepzato treatments in the Los Angeles area.
Why Is It Used?
Hepzato Kit is recommended only for patients who have uveal melanoma that has spread to the liver. Additional studies are being conducted to identify other patients and tumor types that may benefit from this therapy. Most patients who receive melphalan via Hepzato Kit:
- Have metastatic tumors in their liver that cannot be removed surgically
- Have metastatic tumors in 50% or less of the liver
- Either have no metastatic tumors anywhere else in the body, or have metastatic tumors only in certain areas of the body, such as the bone, lymph nodes or subcutaneous tissue
Uveal melanoma has a 40% chance of spreading to the liver, making new, more directed treatments like this one more important than ever for patients with this rare disease.
How It’s Delivered
Treatment using the Hepzato Kit is delivered in a hospital setting under the expert guidance of cancer physicians. The key innovation with this treatment is a device called a Hepatic Delivery System (HDS), which uses small intravenous lines to deliver chemotherapy right to the site of a tumor.
“The chemotherapy is injected through an artery, directly into the liver,” explains Dr. Kessler, who performs the Hepzato Kit treatment in the Los Angeles area.
When the chemotherapy has had time to work, the HDS device then collects the patient’s blood, filters out the chemotherapy medicine and returns the blood back into the patient’s artery.
“This means that the chemotherapy is isolated as it is placed into the liver, filtered out afterward, and then clean blood is put back into the body,” Dr. Kessler adds.
While treatment schedules vary based on each patient’s individual diagnoses, most patients receive around four to six rounds of melphalan treatments, every six to eight weeks.
Does The Hepzato Kit Delivery System Keep Melphalan Chemo in the Body Longer?
No, the melphalan chemotherapy drug doesn’t stay in the body longer than conventional chemo treatments.
“Because the treatment filters the chemo out of the body, any medication is actually removed during the procedure,” Dr. Kessler says.
Melphalan Side Effects
As with any chemotherapy medication, melphalan may lead to some side effects, including:
- Low blood cell counts and low iron levels
- Fatigue
- Nausea or vomiting
- Pain in the muscles, bones or abdomen
- Lower-than-normal levels of iron
- Breathing difficulties
However, because Hepzato Kit delivers the chemotherapy drug in a more direct way – and because it filters the chemotherapy out before the treatment ends – it may lead to fewer side effects than conventional melphalan chemotherapy delivery.
If you or a loved one has been diagnosed with a form of melanoma and would like a second opinion, call us 24/7 at 877-834-8941.