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Also known as melphalan
Melphalan with Hepatic Delivery System · 5 trials · 9 indications
The number and type of adverse events will be assessed per CTCAE version 5.0.
Objective Response Rate (partial or complete) as determined by Independent Central Review Committee. This is assessed per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR
Hepatic Progression Free Survival
| Arm | Type | Description |
|---|---|---|
| Melphalan/HDS | EXPERIMENTAL | Eligible patients will be treated with Melphalan/HDS 3.0 mg/kg Ideal Body Weight (IBW). Melphalan/HDS treatment will be administered every 6 weeks for a total of 6 cycles with an acceptable delay of another 2 weeks before the next planned treatment to allow for recovery of melphalan-related toxicity, if needed. |
| Arm I | EXPERIMENTAL | Patients undergo an isolated hepatic arterial infusion of melphalan over 30 minutes on day 1. Treatment repeats every 4 weeks for 4 courses in the absence of disease progression or unacceptable toxicity. Patients with complete or partial response undergo 2 additional courses in the absence of ongoing or increasing toxicity. |
| Arm II | ACTIVE_COMPARATOR | Patients receive the best alternative therapy comprising supportive care, systemic or regional chemotherapy, hepatic artery (chemo)-embolization, or any other appropriate therapy at the National Cancer Institute or therapy at the discretion of their physician. Patients may cross over to arm I if they have evidence of disease progression. |
| Melphalan/HDS followed by Physician's choice of SOC (eribulin, vinorelbine, or capecitabine) | EXPERIMENTAL | Melphalan/HDS is given as an infusion of Melphalan into the hepatic artery under general anesthesia. This treatment is administered then followed by Physician's choice of SOC (eribulin, vinorelbine, or capecitabine) then repeated for a second cycle of Melphanlan/HDS followed by Physician's choice of SOC. |
| Physician's choice of SOC (eribulin, vinorelbine, or capecitabine) Alone | ACTIVE_COMPARATOR | Physician's choice of SOC (eribulin, vinorelbine, or capecitabine) |
| Melphalan/HDS followed by Consolidation Treatment with Trifluridine-tipiracil plus Bevacizumab | EXPERIMENTAL | Melphalan/HDS is given as an infusion of Melphalan into the hepatic artery under general anesthesia. This treatment is administered twice, 8 weeks apart. Following 2 treatments with Melphalan/HDS, Trifluridine-tipiracil is given 35 mg/m2 up to a maximum of 80 mg per dose orally twice daily with food on Days 1 through 5 and Days 8 through 12 of each 28-day cycle; and intravenous (IV) bevacizumab 5 mg/kg body weight on Days 1 and 15 of each 28-day cycle until disease progression or unacceptable toxicity |
| Trifluridine-tipiracil plus Bevacizumab Alone | ACTIVE_COMPARATOR | Trifluridine-tipiracil plus Bevacizumab is the standard of care for patients with metastatic colorectal cancer. Trifluridine-tipiracil is given 35 mg/m2 up to a maximum of 80 mg per dose orally twice daily with food on Days 1 through 5 and Days 8 through 12 of each 28-day cycle; and intravenous (IV) bevacizumab 5 mg/kg body weight on Days 1 and 15 of each 28-day cycle until disease progression or unacceptable toxicity |
| Name | Type | Description |
|---|---|---|
| Melphalan (3 mg/kg IBW) with Hepatic Delivery System (HDS) | COMBINATION_PRODUCT | Melphalan administered directly to the liver via the Hepatic Delivery System (HDS) infused over a 30 minute period, followed by a 30 minute washout period |
| Melphalan/HDS | COMBINATION_PRODUCT | Melphalan (3 mg/kg IBW) with Hepatic Device System (HDS) |
| melphalan | DRUG | Given throug isolated hepatic artery infusion |
| regional chemotherapy | DRUG | Patients receive the best alternative therapy |
| systemic chemotherapy | DRUG | Patients receive the best alternative therapy |
| hepatic artery embolization | PROCEDURE | Patients receive the best alternative therapy |
| Melphalan/HDS followed by Physician's choice of SOC (eribulin, vinorelbine, or capecitabine) | DRUG | Melphalan/HDS followed by Physician's choice of SOC (eribulin, vinorelbine, or capecitabine) |
| Physician's choice of SOC (eribulin, vinorelbine, or capecitabine) | DRUG | Physician's choice of SOC (eribulin, vinorelbine, or capecitabine) |
| Melphalan/HDS Followed by Consolidation Treatment with Trifluridine-tipiracil plus Bevacizumab | DRUG | Trifluridine-tipiracil plus Bevacizumab Alone |
| Trifluridine-tipiracil plus Bevacizumab Alone | DRUG | Trifluridine-tipiracil plus Bevacizumab Alone |
Inclusion Criteria: 1. Male or female patients ≥ 18 years of age. 2. Patients must weigh ≥ 35 kg (due to possible size limitations with respect to percutaneous catheterization of the femoral artery and vein using the Delcath Hepatic Delivery System). 3. 50% or less histologically or cytologically-p...