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A revolutionary treatment for liver cancer which works by isolating the organ from the rest of the body and ‘bathing’ it in chemotherapy is effective in almost 90 per cent of patients, greatly improving survival rates.


The procedure, pioneered in the UK by Dr Brian Stedman, a consultant interventional radiologist at University Hospital Southampton, involves using two small balloons to divert blood past the liver for an hour while delivering drugs directly in to the organ.


Known as chemosaturation therapy or percutaneous hepatic perfusion (PHP), the technique allows doctors to administer much larger doses of drug than patients would receive with standard chemotherapy as it does not enter the bloodstream and cause unnecessary damage to healthy parts of the body.


Once the drug has been delivered, blood from the liver is drained from the patient and processed through a filtration machine to reduce toxicity before being returned to the patient via the jugular vein.


Dr Stedman and his colleagues have now performed 300 procedures in 100 patients whose form of eye cancer known as ocular melanoma had spread to the liver, called liver metastases.


Ocular melanoma is the most common eye cancer in adults and around 50 per cent develop a secondary cancer – in the liver in more than 85 per cent – with limited treatment options and just 10 per cent to 25 per cent of patients surviving for a year after their diagnosis.


Currently available treatments, which include standard chemotherapy and even a new immunotherapy drug, have poor response rates, with less than 20 per cent of patients benefiting from improved disease control and increased survival.


In a study published in the journal Melanoma Research, Dr Stedman and colleagues found liver cancers were controlled in 88.9 per cent of patients who had received chemosaturation therapy, with 62 per cent of patients surviving for a year and 30 per cent after two years.


The average length of survival in those studied was 15 months but, in some cases, ongoing cycles of chemosaturation therapy have almost removed patients’ cancers completely.


However, despite being incorporated into the available treatment options by the National Institute for Health and Care Excellence (NICE) last year, there is not currently an NHS commissioned service.


This leaves many patients having to self-fund the treatment or seek charitable grants from organisations such as charity OcuMel UK, which has provided more than £100k for patients’ treatments over the past year alone.

“When we first trialled this treatment on two patients in 2012 I said that the development would be a landmark moment in cancer care and it really has proved to be given these results,” said Dr Stedman, who is co-founder of PLANETS Cancer Charity, which has helped fund research into the use of chemosaturation therapy.


“This treatment allows us to cut off an organ from the body for 60 minutes, soak it in a high dose of drug and then filter the blood almost completely clean before returning it and its arrival was much-needed.


“The outlook for patients specifically suffering from cancer which has spread to the liver has been notoriously poor because the effect of standard chemotherapy is limited by the unwanted damage the drug causes to the rest of the body.


“Chemosaturation therapy offers the possibility of repeat intervention and these results demonstrate it offers excellent short and medium-term disease control with improved survival.


“With such a large series of results, it also proves the safety of the system, with patients feeling back to normal within days and maintaining an excellent quality of life during treatment by avoiding many of the unwanted side effects of standard chemotherapy.


“This novel approach demonstrates the ability of science and technology to harness the power of imaging and target cancer treatment to the areas in which treatment is needed but avoid the unwanted damage caused by conventional chemotherapy or surgery on normal tissue.”


PLANETS Cancer Charity helps patients with pancreatic, liver, colorectal, abdominal and neuroendocrine cancer by funding patient support groups, innovative treatments and research.


Dr Stedman and his team are now hoping to launch further studies, funded by PLANETS, using chemosaturation therapy to treat other cancers affecting the liver – and potentially cancers in other parts of the body.


Study co-author Neil Pearce, a consultant hepatobiliary surgeon and co-founder of PLANETS, said: “While we currently only have evidence for this treatment in liver cancer which has spread from the eye, these results may now open the door for future studies with other difficult to treat cancers affecting the liver and we are exploring the potential new research trials.


“There has also been some limited research and case reports in other cancers – including bowel, breast, pancreatic and neuroendocrine – from international centres which suggest potential benefit but would need to be more formally assessed in large clinical trials.


“But these findings show there is real potential for this treatment to extend to more common cancers which is very exciting.”

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