# Characterization of long‐term survivors with liver metastases from uveal melanoma diagnosed between 2005 and 2021

## TL;DR

A study found that 20% of uveal melanoma patients with liver metastases survived three or more years, often with disease control after liver-specific therapies.

## Contribution

The study identifies long-term survivors of uveal melanoma with liver metastases and highlights the effectiveness of liver-directed therapies.

## Key findings

- 33 patients (20% of the cohort) survived three or more years after liver metastases diagnosis.
- 82% of long-term survivors received liver-directed therapies as first-line treatment.
- 93% of patients achieved disease control after the first liver-specific therapy.

## Abstract

Patients with metastatic uveal melanoma (UM) have a poor prognosis. While long‐term survival data in cutaneous melanoma (CM) are promising, such data are lacking in UM and long‐term survivors are rare. In cases of metastases, the liver is affected in 90% of cases and is the main determinant of life expectancy. Immune checkpoint inhibitors (ICI) are less effective in UM than in CM. Therefore, liver‐directed therapies are of high relevance. We evaluated a large cohort of UM patients (n = 167) who had developed liver metastases between 2005 and 2021. We focused on patients who survived 3 years or more from the initial diagnosis of liver metastases and precisely characterized this cohort with regard to systemic therapies (ST) and liver‐specific procedures applied. The last follow‐up (FU) date was October 31, 2024. We identified 33 long‐term survivors, representing 20% of the total cohort. Most patients had additional extrahepatic metastases (23/33; 70%), while 10 patients had liver metastases only. First‐line treatment in the metastatic setting consisted of liver‐directed therapies in most of the cases (27/33; 82%). 90% of the patients had received at least one liver‐specific procedure at any time point during FU and 85% had received ICI at any time point. Response evaluation revealed a high percentage of patients with disease control (DC) after the first ST (17/27; 63%) or first liver‐specific therapy (27/29; 93%), respectively. Notably, all patients with chemosaturation as their first liver‐specific procedure achieved DC. Further data are needed on the combination of liver‐directed therapy and ST, such as ICI or Tebentafusp.

Liver metastasis is an indicator of life expectancy for patients with advanced uveal melanoma (UM). Data on anticipated survival time following the diagnosis of liver metastasis, however, is lacking. The present study analyzed long‐term survival among UM patients who lived three or more years after liver metastases were diagnosed. Although outcomes for metastatic UM were generally poor, one‐fifth of patients survived three or more years. Most patients developed extrahepatic metastases in addition to liver metastases, and the majority showed disease control after the first liver‐specific therapy. Further investigation of survival among UM patients following systemic versus liver‐directed treatment is warranted.