# Transarterial Infusion of Pembrolizumab Plus TACE for Liver Metastases of Melanoma

## TL;DR

A new treatment combining pembrolizumab and TACE was used for liver metastases from melanoma, showing a complete response in one patient.

## Contribution

This is the first reported case of intraarterial pembrolizumab followed by TACE for chemotherapy-resistant melanoma liver metastases.

## Key findings

- A 61-year-old patient showed a complete radiological response after treatment.
- The treatment sequence was feasible and showed promising results in this case.
- Further clinical studies are needed to confirm the efficacy of this approach.

## Abstract

Melanoma hepatic metastases demonstrate limited responsiveness to conventional systemic immune checkpoint blockade therapy, primarily attributed to the hepatic microenvironment's immunosuppressive characteristics. To our knowledge, this is the first reported case describing selective hepatic arterial infusion of pembrolizumab immediately followed by transarterial chemoembolization (TACE) for liver‐dominant melanoma metastases after progression on systemic therapy.

This case report describes an alternative therapeutic strategy employed for a 61‐year‐old female patient with hepatic metastases secondary to chemotherapy‐refractory uveal melanoma. Therapeutic intervention consisted of selective hepatic arterial pembrolizumab infusion immediately succeeded by TACE utilizing carboplatin, mitomycin, and idarubicin combined with lipiodol emulsion. Treatment cycles were administered at eight‐week intervals for two sessions. Radiological assessment 3 months post‐treatment demonstrated a complete response with absence of detectable hepatic malignancy.

This clinical experience represents the initial documentation of sequential intraarterial pembrolizumab followed by TACE in chemotherapy‐resistant melanoma hepatic metastases. While a complete radiologic response was observed, conclusions regarding efficacy cannot be drawn from a single case. This approach appears feasible and warrants further study in well‐designed clinical investigations.