Phase 2 Combination of Melphalan/HDS Via PHP + Tebentafusp in Treating Metastatic Uveal Melanoma
Phase 2 Sequential Treatment With Melphalan/HDS Via Percutaneous Hepatic Perfusion Followed by Tebentafusp in the Treatment of Metastatic Uveal Melanoma
1 other identifier
interventional
18
1 country
1
Brief Summary
This Phase 2 study evaluates the efficacy and safety of sequential treatment with percutaneous hepatic perfusion (PHP) using melphalan/HDS followed by tebentafusp in patients with metastatic uveal melanoma (mUM) with isolated liver metastases. The rationale is that PHP enhances antigen release and immunomodulation, potentially sensitizing tumors to tebentafusp in HLA-A\*02:01-positive patients.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at below P25 for phase_2
Started Dec 2025
Longer than P75 for phase_2
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
December 1, 2025
CompletedFirst Posted
Study publicly available on registry
December 11, 2025
CompletedStudy Start
First participant enrolled
December 31, 2025
CompletedPrimary Completion
Last participant's last visit for primary outcome
December 1, 2030
ExpectedStudy Completion
Last participant's last visit for all outcomes
December 1, 2030
March 31, 2026
March 1, 2026
4.9 years
December 1, 2025
March 26, 2026
Conditions
Outcome Measures
Primary Outcomes (1)
Progression Free Survival (PFS)
PFS will be studied as time-to-event defined by the first documented disease progression or death due to any cause, whichever occurs first, from the start date of the study treatment. PFS will be determined based on tumor assessment (RECIST version 1.1 criteria).
Up to 24 months
Secondary Outcomes (7)
Objective Response Rate (ORR)
Up to 24 months
Clinical Benefit Rate (CBR)
Up to 24 months
Hepatic PFS (hPFS)
Up to 24 months
Overall Survival (OS)
Up to 24 months
Melanoma-Specific Survival (MSS)
Up to 24 months
- +2 more secondary outcomes
Study Arms (1)
Sequential PHP with Melphalan/HDS followed by Tebentafusp
EXPERIMENTALPatients will undergo two percutaneous hepatic perfusion (PHP) procedures with melphalan/HDS, spaced 6-8 weeks apart. Tebentafusp will be initiated within 6 weeks (+/- 2 weeks) after the second PHP and administered weekly for 1 year. Additional PHP procedures (up to 6 total) may be performed as standard of care if disease progression occurs while on tebentafusp.
Interventions
3 mg/kg ideal body weight (max 220 mg) infused via hepatic artery catheter.
20 mcg IV day 1, 30 mcg day 8, 68 mcg day 15, then weekly thereafter.
Eligibility Criteria
You may qualify if:
- Patient is ≥18 years of age on the day of signing informed consent.
- ECOG performance status of 0 or 1.
- Histologically or cytologically confirmed liver metastasis of uveal melanoma.
- HLA-A\*02:01 positive status.
- Measurable disease by computed tomography (CT) per RECIST 1.1 with at least one target lesion identified in the liver.
- Patient deemed suitable for PHP and tebentafusp.
- Female patient of childbearing potential should have a negative urine or serum pregnancy test within 72 hours prior to receiving the first treatment. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required.
- Female patients of childbearing potential must be willing to use an adequate method of contraception, for the course of the study through 150 days after the last dose of study medication. Note: Abstinence is acceptable if this is the usual lifestyle and preferred contraception for the subject.
- Male patients of childbearing potential must agree to use an adequate method of contraception, starting with the first dose of study therapy through 150 days after the last dose of study therapy. Abstinence is acceptable if this is the usual lifestyle and preferred contraception for the subject.
- Limited extrahepatic disease would be allowed initially, that can be treated with stereotactic body radiation therapy (SBRT) or surgical resection prior to the start of tebentafusp. This concept is similar to the FOCUS trial - definition of "treatable" limited disease at the discretion of the PI.
- Ability to provide and understand written informed consent prior to any study procedures.
You may not qualify if:
- Life expectancy of less than 6 months.
- More than 50% of the liver volume replaced by tumor as measured by MRI.
- History of congestive heart failure, active cardiac conditions, including unstable coronary syndromes (unstable or severe angina, recent myocardial infarction), significant arrhythmias and severe valvular disease that precludes the use of general anesthesia.
- History or evidence of clinically significant pulmonary disease e.g. severe COPD that precludes the use of general anesthesia.
- Patients who are unable to undergo general anesthesia for any reason.
- Reduced renal function defined as Serum Creatinine \>=1.5xULN or Creatinine Clearance \< 40 mL/min, calculated using the Cockcroft and Gault formula.
- Reduced hepatic function (defined as AST, ALT, bilirubin\>2.5\*ULN and PT-INR\>1.5) or medical history of liver cirrhosis (Child-Pugh Class B or C) or evidence of portal hypertension by history, endoscopy or radiology.
- Hemoglobin \<90 g/L or platelets \<100x109/L or neutrophils \<1.5x109/L.
- Use of live vaccines four weeks before the last study treatment.
- History of severe reactions to melphalan, heparin or iodine contrast. Iodine contrast reaction history patients permitted if patient will be treated with pre-meds, or if still problematic, treating physician may switch to MRI TAP.
- Known human immunodeficiency virus (HIV) infection, acquired immunodeficiency syndrome (AIDS), hepatitis B or hepatitis C.
- Active autoimmune disease or a documented history of autoimmune disease requiring active systemic immunosuppressive treatment. Type-1 diabetes, atopic dermatitis, and hypothyroidism are exceptions to this.
- A condition requiring systemic treatment with either corticosteroids (\>10 mg daily prednisone equivalents) or other immunosuppressive medications within 14 days of study drug administration. Inhaled or topical steroids and adrenal replacement doses \>10 mg daily prednisone equivalents are permitted in the absence of active autoimmune disease.
- Has a known additional malignancy that is progressing or requires active treatment.
- Pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 150 days after the last dose of study drug.
- +2 more criteria
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Moffitt Cancer Center
Tampa, Florida, 33612, United States
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Jonathan Zager, MD, FACS
Moffitt Cancer Center
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- phase 2
- Allocation
- NA
- Masking
- NONE
- Purpose
- TREATMENT
- Intervention Model
- SINGLE GROUP
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
December 1, 2025
First Posted
December 11, 2025
Study Start
December 31, 2025
Primary Completion (Estimated)
December 1, 2030
Study Completion (Estimated)
December 1, 2030
Last Updated
March 31, 2026
Record last verified: 2026-03