A significant advancement in the treatment landscape for metastatic uveal melanoma (mUM) has emerged with the inclusion of Delcath Systems’ CHEMOSAT Hepatic Delivery System and HEPZATO KIT in the latest clinical guidelines from European Society for Medical Oncology (ESMO) and EURACAN. This update reinforces the growing role of liver-directed therapies in managing a disease where up to 90% of patients develop liver metastases.
The CHEMOSAT system delivers melphalan directly to the liver through a technique known as percutaneous hepatic perfusion (M-PHP). By isolating liver circulation and filtering blood during treatment, this approach allows for high-dose chemotherapy while limiting systemic toxicity. This targeted strategy is particularly important in ocular melanoma, where effective systemic options remain limited.
In parallel, the National Comprehensive Cancer Network (NCCN) continues to recognize HEPZATO KIT as a Category 2A recommended treatment for patients with hepatic-dominant metastatic uveal melanoma. This dual recognition across U.S. and European guidelines highlights increasing clinical confidence in liver-directed approaches.
The updated ESMO–EURACAN guidelines position M-PHP as a key regional therapy, especially for patients with unresectable liver metastases affecting less than 50% of the liver. Clinical evidence from Phase 3 trials demonstrates improved hepatic progression-free survival, overall progression-free survival, and response rates compared to alternative care options. These outcomes are critical in a cancer type historically associated with poor prognosis.
Importantly, the guidelines emphasize a multidisciplinary treatment approach. Liver-directed therapies like CHEMOSAT are now considered alongside systemic treatments such as tebentafusp and immunotherapies. This integrated strategy allows physicians to tailor care based on disease extent, genetic markers such as HLA-A*02:01 status, and patient-specific factors.
For the ocular melanoma community, this update represents more than a guideline change—it reflects meaningful progress. As research continues to evolve, therapies like CHEMOSAT and HEPZATO KIT are helping redefine standards of care, offering patients more targeted, effective options and renewed hope in the fight against metastatic disease.