---
title: "Percutaneous hepatic perfusion vs best alternative care for metastatic uveal melanoma: meta-analys"
id: "pubmed-42330566"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42330566"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42330566/"
doi: "10.1016/j.ejca.2026.116893"
published_at: "2026-08-26T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Percutaneous hepatic perfusion vs best alternative care for metastatic uveal melanoma: meta-analys
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42330566
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42330566/)
- **DOI:** [10.1016/j.ejca.2026.116893](https://doi.org/10.1016%2Fj.ejca.2026.116893)
- **Published At:** 2026-08-26T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This meta-analysis pooled data on **percutaneous hepatic perfusion (PHP)** versus best alternative care (BAC) for patients with **metastatic uveal melanoma (mUM)** to assess efficacy and safety. - Systematic searches of PubMed, Embase, Cochrane, and Web of Science were performed through Feb 17, 2026. Eleven studies met inclusion criteria, including nine PHP cohorts and three BAC cohorts (one study reported both). - The pooled sample included 455 patients receiving PHP and 125 patients receiving BAC drawn from randomized trials of PHP or isolated hepatic perfusion. - Primary endpoints were 1-year and 2-year overall survival (OS), median OS (mOS), 1-year progression-free survival (PFS), median PFS (mPFS), overall response rate (ORR), and safety. - Pooled 1-year OS was 65.5% (95% CI 52.8–75.5%) for PHP and 64.3% (95% CI 13.3–90.7%) for BAC; pooled 2-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 was 17.3 months (95% CI 11.8–22.8) for PHP versus 14.0 months (95% CI 4.3–23.6) for BAC. - **ORR** was higher with PHP (47.4%) versus BAC (6.0%); 1-year PFS was 30.1% for PHP versus 6.4% for BAC, and mPFS 7.7 months versus 2.6 months respectively. - Hematologic adverse events were the most commonly reported toxicities in PHP studies. - Authors conclude PHP is associated with improved **ORR** and **PFS** compared with BAC, but no clear survival advantage was observed in pooled OS estimates. - Conflict-of-interest disclosures noted relationships between some authors and Delcath Systems Inc.; other methodological limitations or subgroup details were not fully reported in the abstract and require consulting the full text for more detail.
## Clinical Analysis & Structured Key Points
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Epub 2026 Jun 19. # Percutaneous hepatic perfusion versus best alternative care as treatment for metastatic uveal melanoma: A meta-analysis [Linde van den Hoek](https://pubmed.ncbi.nlm.nih.gov/?term=van+den+Hoek+L&cauthor_id=42330566)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42330566/#full-view-affiliation-1 "Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands; Department of Medical Oncology, Leiden University Medical Centre, Leiden, the Netherlands."), [Olaf Dekkers](https://pubmed.ncbi.nlm.nih.gov/?term=Dekkers+O&cauthor_id=42330566)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42330566/#full-view-affiliation-2 "Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands."), [Mark Burgmans](https://pubmed.ncbi.nlm.nih.gov/?term=Burgmans+M&cauthor_id=42330566)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42330566/#full-view-affiliation-3 "Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands."), [Ellen Kapiteijn](https://pubmed.ncbi.nlm.nih.gov/?term=Kapiteijn+E&cauthor_id=42330566)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42330566/#full-view-affiliation-4 "Department of Medical Oncology, Leiden University Medical Centre, Leiden, the Netherlands. Electronic address: H.W.Kapiteijn@lumc.nl.") Affiliations Expand ### Affiliations * 1 Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands; Department of Medical Oncology, Leiden University Medical Centre, Leiden, the Netherlands. * 2 Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands. * 3 Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands. * 4 Department of Medical Oncology, Leiden University Medical Centre, Leiden, the Netherlands. Electronic address: H.W.Kapiteijn@lumc.nl. * PMID: **42330566** * DOI: [ 10.1016/j.ejca.2026.116893 ](https://doi.org/10.1016/j.ejca.2026.116893) Free article Item in Clipboard Meta-Analysis # Percutaneous hepatic perfusion versus best alternative care as treatment for metastatic uveal melanoma: A meta-analysis Linde van den Hoek et al. Eur J Cancer. 2026. Free article Show details Display options Display options Format Abstract PubMed PMID Eur J Cancer Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Eur+J+Cancer%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Eur+J+Cancer%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42330566/) . 2026 Aug 26:244:116893. doi: 10.1016/j.ejca.2026.116893. Epub 2026 Jun 19. ### Authors [Linde van den Hoek](https://pubmed.ncbi.nlm.nih.gov/?term=van+den+Hoek+L&cauthor_id=42330566)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42330566/#short-view-affiliation-1 "Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands; Department of Medical Oncology, Leiden University Medical Centre, Leiden, the Netherlands."), [Olaf Dekkers](https://pubmed.ncbi.nlm.nih.gov/?term=Dekkers+O&cauthor_id=42330566)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42330566/#short-view-affiliation-2 "Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands."), [Mark Burgmans](https://pubmed.ncbi.nlm.nih.gov/?term=Burgmans+M&cauthor_id=42330566)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42330566/#short-view-affiliation-3 "Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands."), [Ellen Kapiteijn](https://pubmed.ncbi.nlm.nih.gov/?term=Kapiteijn+E&cauthor_id=42330566)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42330566/#short-view-affiliation-4 "Department of Medical Oncology, Leiden University Medical Centre, Leiden, the Netherlands. Electronic address: H.W.Kapiteijn@lumc.nl.") ### Affiliations * 1 Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands; Department of Medical Oncology, Leiden University Medical Centre, Leiden, the Netherlands. * 2 Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands. * 3 Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands. * 4 Department of Medical Oncology, Leiden University Medical Centre, Leiden, the Netherlands. Electronic address: H.W.Kapiteijn@lumc.nl. * PMID: **42330566** * DOI: [ 10.1016/j.ejca.2026.116893 ](https://doi.org/10.1016/j.ejca.2026.116893) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Evidence on the efficacy of percutaneous hepatic perfusion (PHP) in metastatic uveal melanoma (mUM) is largely derived from single-arm studies without comparators, complicating interpretation of treatment benefit, particularly for survival. This meta-analysis aimed to synthesize available evidence on the efficacy and safety of PHP in patients with mUM and compare outcomes with best alternative care (BAC). **Material and methods:** PubMed, Embase, Cochrane, and Web of Science were searched from database inception to Feb 17, 2026. Studies evaluating PHP in patients with mUM and BAC cohorts derived from randomized trials of PHP or isolated hepatic perfusion were included. The 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. **Results:** Eleven studies were included (one reporting on both PHP and BAC), comprising 455 patients treated with PHP (nine studies) and 125 treated with BAC (three studies). The pooled 1-year OS was 65.5% (95% CI 52.8-75.5%) for PHP and 64.3% (95% CI 13.3-90.7%) for BAC. The pooled 2-year OS was 35.4% (95% CI 28.5-42.4%) and 28.1% (95% CI 9.6-50.2%), and mOS 17.3 months (95% CI 11.8-22.8) and 14.0 months (95% CI 4.3-23.6), respectively. PHP was associated with higher ORR (47.4% vs 6.0%), longer 1-year PFS (30.1% vs 6.4%) and mPFS (7.7 vs 2.6 months). Hematologic adverse events were the most frequently reported toxicities in PHP studies. **Conclusion:** PHP is associated with improved ORR and PFS compared with BAC in patients with mUM, although no clear survival benefit was observed. **Keywords:** Metastatic uveal melanoma; Percutaneous hepatic perfusion. Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Linde van den Hoek reports a relationship with Delcath Systems Inc that includes: funding grants. Mark Burgmans reports a relationship with Delcath Systems Inc that includes: speaking and lecture fees. Ellen Kapiteijn reports a relationship with Delcath Systems Inc that includes: consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. ## Similar articles * [ Results of a Randomized Controlled Multicenter Phase III Trial of Percutaneous Hepatic Perfusion Compared with Best Available Care for Patients with Melanoma Liver Metastases. ](https://pubmed.ncbi.nlm.nih.gov/26597368/) Hughes MS, Zager J, Faries M, Alexander HR, Royal RE, Wood B, Choi J, McCluskey K, Whitman E, Agarwala S, Siskin G, Nutting C, Toomey MA, Webb C, Beresnev T, Pingpank JF.Hughes MS, et al.Ann Surg Oncol. 2016 Apr;23(4):1309-19. doi: 10.1245/s10434-015-4968-3. Epub 2015 Nov 23.Ann Surg Oncol. 2016.PMID: 26597368Free PMC article.Clinical Trial. * [ An Open-label, Randomized Study of Melphalan/Hepatic Delivery System Versus Best Alternative Care in Patients with Unresectable Metastatic Uveal Melanoma. ](https://pubmed.ncbi.nlm.nih.gov/40192993/) Zager JS, Orloff M, Ferrucci PF, Choi J, Eschelman DJ, Glazer ES, Ejaz A, Howard JH, Richtig E, Ochsenreither S, Reddy SA, Lowe MC, Beasley GM, Gesierich A, Bender A, Gschnell M, Dummer R, Rivoire M, Arance A, Fenwick SW, Sacco JJ, Haferkamp S, Weishaupt C, John J, Wheater M, Ottensmeier CH.Zager JS, et al.Ann Surg Oncol. 2025 Jul;32(7):4976-4988. doi: 10.1245/s10434-025-17231-x. Epub 2025 Apr 7.Ann Surg Oncol. 2025.PMID: 40192993Free PMC article.Clinical Trial. * [ Chemosaturation with Percutaneous Hepatic Perfusion: Outcome and Safety in Patients with Metastasized Uveal Melanoma. ](https://pubmed.ncbi.nlm.nih.gov/33535258/) Dewald CLA, Hinrichs JB, Becker LS, Maschke S, Meine TC, Saborowski A, Schönfeld LJ, Vogel A, Kirstein MM, Wacker FK.Dewald CLA, et al.Rofo. 2021 Aug;193(8):928-936. doi: 10.1055/a-1348-1932. Epub 2021 Feb 3.Rofo. 2021.PMID: 33535258English, German. * [ Meta-analysis in metastatic uveal melanoma to determine progression free and overall survival benchmarks: an international rare cancers initiative (IRCI) ocular melanoma study. ](https://pubmed.ncbi.nlm.nih.gov/31150059/) Khoja L, Atenafu EG, Suciu S, Leyvraz S, Sato T, Marshall E, Keilholz U, Zimmer L, Patel SP, Piperno-Neumann S, Piulats J, Kivelä TT, Pfoehler C, Bhatia S, Huppert P, Van Iersel LBJ, De Vries IJM, Penel N, Vogl T, Cheng T, Fiorentini G, Mouriaux F, Tarhini A, Patel PM, Carvajal R, Joshua AM.Khoja L, et al.Ann Oncol. 2019 Aug 1;30(8):1370-1380. doi: 10.1093/annonc/mdz176.Ann Oncol. 2019.PMID: 31150059 * [ Evaluating the efficacy and safety of tebentafusp in the treatment of metastatic uveal melanoma: a 2025 update systematic review and meta-analysis. ](https://pubmed.ncbi.nlm.nih.gov/41170451/) Wang Y, Sun W, Wang B.Wang Y, et al.Front Oncol. 2025 Oct 15;15:1667282. doi: 10.3389/fonc.2025.1667282. eCollection 2025.Front Oncol. 2025.PMID: 41170451Free PMC article. 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