Metastatic uveal melanoma (mUM) frequently involves the liver and is associated with poor prognosis. Evidence for regional liver-directed chemotherapy by percutaneous hepatic perfusion (PHP) has largely come from single-arm series, which complicates assessment of treatment benefit for survival outcomes. This meta-analysis synthesized available studies comparing PHP with best alternative care (BAC) to evaluate efficacy and safety in patients with mUM.
The authors searched PubMed, Embase, Cochrane, and Web of Science from database inception to Feb 17, 2026. Eligible studies evaluated PHP in patients with mUM and included BAC cohorts derived from randomized trials of PHP or isolated hepatic perfusion. The report in PubMed is a meta-analysis published in Eur J Cancer (Epub Jun 19, 2026).
Pre-specified endpoints were 1-year overall survival (OS), 2-year OS, median OS (mOS), 1-year progression-free survival (PFS), median PFS (mPFS), overall response rate (ORR), and safety. Random-effects meta-analyses were performed using restricted maximum likelihood estimation. The abstract reports pooled proportions, medians, and corresponding 95% confidence intervals for these outcomes.
Eleven studies met inclusion criteria; one study reported both PHP and BAC cohorts. Across included studies there were 455 patients treated with PHP (reported in nine studies) and 125 patients treated with BAC (reported in three studies). BAC cohorts were derived from randomized trials of PHP or of isolated hepatic perfusion as noted in the selection strategy. Detailed study-level characteristics (for example study design, prior therapies, lines of therapy, or eligibility criteria) are not provided in the abstract and require the full text for further granularity.
The pooled 1-year OS for patients receiving PHP was 65.5% (95% CI 52.8–75.5%). For BAC cohorts the pooled 1-year OS was 64.3% (95% CI 13.3–90.7%). Two-year OS was 35.4% (95% CI 28.5–42.4%) for PHP and 28.1% (95% CI 9.6–50.2%) for BAC. Median OS (mOS) was reported as 17.3 months (95% CI 11.8–22.8) for PHP and 14.0 months (95% CI 4.3–23.6) for BAC. The authors concluded that no clear survival benefit was observed with PHP relative to BAC based on pooled OS measures.
By contrast with OS, progression-free survival and tumor response favored PHP. The pooled 1-year PFS was 30.1% for PHP versus 6.4% for BAC. Median PFS was 7.7 months with PHP compared with 2.6 months with BAC. The overall response rate (ORR) was notably higher in the PHP group at 47.4% versus 6.0% in BAC cohorts. These pooled differences indicate improved disease control and objective tumor responses with regional chemosaturation by PHP in mUM.
Hematologic adverse events were the most frequently reported toxicities in studies of PHP, as summarized in the abstract. The meta-analysis abstract does not provide a comprehensive breakdown of specific grades, rates of non-hematologic adverse events, treatment-related mortality, or long-term toxicity. For a detailed safety profile and comparative adverse-event rates, consult the full text.
The authors report that PHP is associated with improved ORR and PFS compared with BAC in patients with metastatic uveal melanoma. However, pooled measures of overall survival did not demonstrate a clear benefit for PHP over BAC. The findings suggest that PHP may provide better hepatic disease control and higher response rates, but whether these translate into robust survival advantages remains uncertain based on the available pooled data presented in the abstract.
The publication includes a declaration of competing interests: several authors report relationships with Delcath Systems Inc., including funding grants, speaking fees, and consulting or advisory roles. The abstract does not report full details of study-level heterogeneity, risk-of-bias assessments, subgroup analyses, or sensitivity analyses. Additional methodological details and complete results (including granular adverse-event reporting and study characteristics) are available in the full article and should be reviewed to interpret applicability to clinical practice.
Note: This summary is based on the PubMed abstract for the meta-analysis (PMID 42330566). Where the abstract did not report specific methodological or numerical details, those elements are indicated as not reported in the abstract and require consultation of the full text for confirmation.