Ep 33: Percutaneous Hepatic Infusion for Uveal Melanoma
10/14/24 • 41 min
Summary
Warning: we recorded ANOTHER 40-minute episode on uveal melanoma! But this time we decided *not* to split it into 2 episodes. So dig in for a long one...there's the use of props at the end!
In this conversation, James and Sapna discuss the FOCUS trial and the use of the melphalan hepatic delivery system. The discussion highlights the importance of understanding the differences between infusion and perfusion, the implications of study design on dropout rates, and the future directions for treatment in this area.
Takeaways
The FOCUS trial showed a high dropout rate due to unappealing control arms.
Melphalan hepatic delivery is a new approach for treating uveal melanoma.
Understanding the difference between infusion and perfusion is crucial for treatment efficacy.
Patient selection is key, especially regarding liver involvement.
The objective response rate of 36.3% is significant for this patient population.
Quality of life post-treatment has improved compared to previous methods.
The study design faced challenges due to high dropout rates.
Future studies may need to consider alternative endpoints for efficacy.
The treatment requires a specialized care team for administration.
Overall survival data is still pending for the new treatment approach.
Keywords
melphalan, HDS, uveal melanoma, FOCUS trial, treatment efficacy, patient selection, infusion, perfusion, clinical trials, oncology
Sound Bites
"This is a pitiful fact check."
"The hazard ratio for that study for OS was basically one."
"It's not a closed system of catheters."
Chapters
00:00 Introduction and Icebreaker
02:31 Overview of the FOCUS Trial
05:09 Designing Clinical Trials with Challenging Control Arms
08:50 Procedure and Treatment Details
18:30 Objective Response Rate and Duration of Response
20:49 Side Effects and Considerations for Patient Selection
33:24 Fact Check
34:07 Dropout in the FOCUS Trial and the Checkmate 037 Study
36:47 Infusion versus Perfusion - what's the difference
39:54 Clarifying the M Category for Melanoma
Summary
Warning: we recorded ANOTHER 40-minute episode on uveal melanoma! But this time we decided *not* to split it into 2 episodes. So dig in for a long one...there's the use of props at the end!
In this conversation, James and Sapna discuss the FOCUS trial and the use of the melphalan hepatic delivery system. The discussion highlights the importance of understanding the differences between infusion and perfusion, the implications of study design on dropout rates, and the future directions for treatment in this area.
Takeaways
The FOCUS trial showed a high dropout rate due to unappealing control arms.
Melphalan hepatic delivery is a new approach for treating uveal melanoma.
Understanding the difference between infusion and perfusion is crucial for treatment efficacy.
Patient selection is key, especially regarding liver involvement.
The objective response rate of 36.3% is significant for this patient population.
Quality of life post-treatment has improved compared to previous methods.
The study design faced challenges due to high dropout rates.
Future studies may need to consider alternative endpoints for efficacy.
The treatment requires a specialized care team for administration.
Overall survival data is still pending for the new treatment approach.
Keywords
melphalan, HDS, uveal melanoma, FOCUS trial, treatment efficacy, patient selection, infusion, perfusion, clinical trials, oncology
Sound Bites
"This is a pitiful fact check."
"The hazard ratio for that study for OS was basically one."
"It's not a closed system of catheters."
Chapters
00:00 Introduction and Icebreaker
02:31 Overview of the FOCUS Trial
05:09 Designing Clinical Trials with Challenging Control Arms
08:50 Procedure and Treatment Details
18:30 Objective Response Rate and Duration of Response
20:49 Side Effects and Considerations for Patient Selection
33:24 Fact Check
34:07 Dropout in the FOCUS Trial and the Checkmate 037 Study
36:47 Infusion versus Perfusion - what's the difference
39:54 Clarifying the M Category for Melanoma
Previous Episode
Ep 32: Ipi Nivo for Uveal Melanoma
Summary
Find out which host is a french fry aficianado, who loves a doner kebab as a guilty pleasure, and other cheeky indulgences (Lebowski's, Gettysburger, Union Rings, Freedom Fries, Law & Order: SVU...)
In this conversation, hosts Sapna Patel and James Larkin discuss the latest findings and studies related to uveal melanoma treatments, particularly focusing on the combination of nivolumab and ipilimumab. They explore the differences in treatment outcomes between studies conducted in Spain and the US, the efficacy of these treatments, and the implications for future research and clinical practice.
Keywords
Uveal melanoma, nivolumab, ipilimumab, treatment studies, immune checkpoint inhibitors, clinical trials, response rates, survival curves, adverse events, cancer research
Takeaways
Nivolumab and ipilimumab are key treatments for uveal melanoma.
The Spanish study showed an objective response rate of 11.5%.
The US study had a higher response rate of 19%.
Adverse events differ between studies, indicating potential global differences.
Genotyping of patients is crucial for understanding treatment responses.
The primary endpoints of the studies were different, affecting comparisons.
Combination therapies may offer additive or synergistic effects.
Monitoring liver enzymes is essential during treatment.
Response characteristics can inform future treatment decisions.
Sequencing treatments may enhance patient outcomes in uveal melanoma.
Titles
Exploring Uveal Melanoma Treatments
Nivolumab and Ipilimumab: A Deep Dive
Chapters
00:00 Introduction and Guilty Pleasures
03:40 Efficacy of Ipilimumab and Nivolumab in Uveal Melanoma
10:59 Sequencing Strategies and Biomarkers in Uveal Melanoma
14:47 Long-Term Survival in Uveal Melanoma
16:41 Monitoring Liver Enzymes in Checkpoint Inhibitor Therapy
24:09 Fact Check: Nivolumab Plus Ipilimumab in Uveal Melanoma Studies
26:38 Efficacy Metrics: GEM 1402 Study vs. MD Anderson Study
27:35 Adverse Events: Spanish Study vs. US Study
28:32 Publication and Editorial in Journal of Clinical Oncology
Next Episode
Ep 34: CHOPIN & SCANDIUM trials for Uveal Melanoma
Summary
In this episode of Melanoma Matters, hosts James Larkin and Sapna Patel discuss a couple of liver-directed trials in metastatic uveal melanoma. They focus on the CHOPIN and SCANDIUM trials, the combination of liver-directed therapies with systemic treatments, and the safety and efficacy of these approaches. The conversation highlights the innovative efforts of European investigators and the need for adaptive trial designs in rare diseases.
Keywords
melanoma, uveal melanoma, SCANDIUM, CHOPIN, liver directed therapy, systemic therapy, checkpoint inhibitors, cancer research, clinical trials, treatment options
Takeaways
We have limited treatment options for metastatic uveal melanoma.
Combining liver-directed therapy with systemic therapy is being explored.
Future trials are needed to understand optimal sequencing of therapies.
Adaptive trial designs may be challenging in rare cancers.
European investigators are leading innovative trials in this field.
The importance of collaboration in cancer research is emphasized.
Sound Bites
"We have a couple of approved agents."
"Is it safe to combine these therapies?"
"The IHP treatment had a superior response rate."
Chapters
00:00 Introduction and Icebreaker Question
01:52 Background and Objectives of the Studies
04:17 Results and Conclusions of the Scandium, Scandium-2, and Chopin Studies
06:28 Feasibility of Adaptive Trials for Rare Cancers
08:52 The Importance of International Collaboration in Uveal Melanoma Research
09:48 Closing Remarks and Future Directions
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