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

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.