O’Donoghue C, et al. - Researchers here delineated a single-center experience with over 200 isolated limb infusion (ILI) for patients with locally advanced cutaneous malignancies and sarcoma. They recognized ILI as a well-tolerated procedure for these patients. ILI responders indicated an appreciably longer time to in-field progression-free survival (IPFS), while melanoma responders also indicated a distant metastatic-free survival (DMFS) and overall survival (OS) advantage.

Methods

• Researchers performed an analysis of single-institution, prospectively collected database for intention-to-treat with ILI.

Results

• From 2007 to 2016, 205 procedures were performed on 163 patients (201 were successfully completed), and four malignancies were treated: melanoma (72.1% of all ILIs), sarcoma (23.4%), squamous cell carcinoma (SCC; 2.0%) and Merkel cell carcinoma (MCC; 2.5%).
• Researchers observed a median grade II regional Wieberdink toxicity score, with 88.1% of patients experiencing grade II or less.
• Median follow-up of 21.8 months was performed; overall response rate (ORR) was 59.0% for melanoma, 48.9% for sarcoma, 50.0% for SCC, and 60.0% for MCC.
• There appeared a significant difference (p = 0.04) between upper (76.9%) and lower extremity (55.1%) ORR in patients with melanoma.
• On comparing responders with nonresponders, patients with melanoma indicated markedly longer in-field progression-free survival (IPFS; 14.1 vs. 3.2 months, p < 0.001), distant metastatic-free survival (DMFS; not reached vs. 25.8 months, p = 0.006), and overall survival (OS; 56.0 vs. 26.7 months, p = 0.0004).
• Sarcoma responders indicated a markedly longer IPFS (13.0 vs. 2.7 months, p < 0.0001), but there appeared no significant distant metastatic or OS advantage.
• Sarcoma patients indicated an overall limb salvage rate of 68.4% over a median follow-up of 19.3 months.