title: Chemosaturation Percutaneous Hepatic Perfusion: A Systematic Review.
abstract: The Hepatic CHEMOSAT®Delivery System is an innovative medical device for the treatment of patients with unresectable primary liver tumors or unresectable hepatic metastases from solid organ malignancies. This system is used to perform chemosaturation percutaneous hepatic perfusion (CS-PHP), a procedure in which a high dose of the chemotherapeutic agent melphalan is delivered directly to the liver while limiting systemic exposure. In a clinical trial program, CS-PHP with melphalan significantly improved hepatic progression-free survival in patients with unresectable hepatic metastases from ocular or cutaneous melanoma. Clinically meaningful hepatic responses were also observed in patients with hepatocellular carcinoma or neuroendocrine tumors. Furthermore, the results of published studies and case reports demonstrated that CS-PHP with melphalan resulted in favorable tumor response rates in a range of tumor histologies (ocular or cutaneous melanoma, colorectal cancer, and hepatobiliary tumors). Analyses of the safety profile of CS-PHP revealed that the most common adverse effects were hematologic events (thrombocytopenia, anemia, and neutropenia), which were clinically manageable. Taken together, these findings indicate that CS-PHP is a promising locoregional therapy for patients with primary and secondary liver tumors and has a acceptable safety profile.
  
  
  
  Delcath Systems Inc., New York, NY, USA.
authors: Department of Gastroenterology, Hepatology and Endocrinology, Medizinische Hochschule Hannover, Hannover, Germany. vogel.arndt@mh-hannover.de.
authors: Arndt
authors: A
authors: Vogel
authors: Department of Anaesthesiology, University Hospital Southampton, Tremona Road, Southampton, Hampshire, UK.
authors: Sanjay
authors: S
authors: Gupta
authors: Department of Radiology and Neuroradiology, Asklepios Clinic Hamburg-Barmbek, Hamburg, Germany.
authors: Martin
authors: M
authors: Zeile
authors: Department of Anaesthesiology, University Clinic Heidelberg, Heidelberg, Germany.
authors: Rebecca
authors: R
authors: von Haken
authors: Department of Radiology and Neuroradiology, Asklepios Clinic Hamburg-Barmbek, Hamburg, Germany.
authors: Roland
authors: R
authors: Brüning
authors: Department of Anaesthesiology, University Clinic Frankfurt, Frankfurt am Main, Germany.
authors: Gösta
authors: G
authors: Lotz
authors: Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands.
authors: Alexander
authors: A
authors: Vahrmeijer
authors: Institute of Diagnostic and Interventional Radiology, University Clinic Frankfurt, Frankfurt am Main, Germany.
authors: Thomas
authors: T
authors: Vogl
authors: Institute of Diagnostic and Interventional Radiology, Medizinische Hochschule Hannover, Hannover, Germany.
authors: Frank
authors: F
authors: Wacker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000295:instrumentation*; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D008545:Melanoma / Q000188:drug therapy*; D008558:Melphalan / Q000627:therapeutic use*; D008875:Middle Aged; D012878:Skin Neoplasms / Q000188:drug therapy*; D000096142:Cutaneous Malignant Melanoma
chemical_list: D000970:Antineoplastic Agents; D008558:Melphalan
keywords: Chemosaturation percutaneous hepatic perfusion; Hepatic metastases; Melphalan; Oncology; Primary liver tumors