Melphalan Chemosaturation for Primary or Metastatic Cancer in the Liver


The National Institute for Health and Care Excellence (NICE) has published draft guidance on the use of melphalan chemosaturation with percutaneous hepatic artery perfusion and hepatic vein isolation for primary or metastatic cancer in the liver.

Evidence on the safety of the procedure shows there are serious but well-recognised complications. There is some evidence of short-term tumour response, but evidence on quality of life and survival was inadequate in quality and quantity. Therefore, NICE recommends that this procedure should only be used in the context of research.

The draft guidance also advises that the procedure should only be done in specialist centres by a multidisciplinary team that includes an interventional radiologist, an anaesthetist and a trained clinical perfusion scientist.

NICE is calling for further research in the form of randomised controlled trials comparing the procedure against current best practice.

The decision is based on the findings of a rapid review of the published literature on the efficacy and safety of the procedure. Evidence from nine sources was reviewed – one randomised controlled trial, one non-randomised comparative study and seven case series.

The draft guidance is currently open to public consultation. The deadline for receipt of comments is 23 July 2020. It is expected that the final recommendations will be published in December 2020.

This article originally appeared on Univadis, part of the Medscape Professional Network.