Isolated Limb Infusion for In-Transit Melanoma and Extremity Sarcomas
Isolated Limb Infusion (ILI) is a regional technique which involves temporarily isolating the blood supply to an extremity to concentrate chemotherapy treatment there.
It’s a minimally invasive procedure for delivering high doses of chemotherapy to treat recurrent in-transit disease in a limb, including melanoma and sarcoma.
Jeffrey M. Farma, MD, FACS, performed Fox Chase Cancer Center's first Limb Infusion in December 2012. He is Co-Director of the Cutaneous Oncology Program at Fox Chase Cancer Center in Philadelphia.
Only a handful of physicians nationwide offer ILI.
At Fox Chase Cancer Center,
it’s Dr. Jeffrey Farma.
Metastatic melanoma and extremity sarcoma are some of the hardest cancers to treat. Treatment for patients with advanced melanoma and sarcoma (that has spread to other parts of the body) may include surgery, radiation therapy, chemotherapy, interferon therapy, biologic/immunotherapy and/or innovative therapies using new drugs to fight the disease.
What is Limb Infusion?
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A tourniquet is used to stop the blood circulation in the affected limb. A catheter is inserted into both the artery and vein and used to circulate a high dose of the treatment drug into the limb without the stress on other organs that would normally occur.
With ILI, the effects of chemotherapy can be concentrated regionally in one area, easing the strain and toxicity on the full body that can accompany standard chemotherapy. It also allows a much higher concentration of the dose than a standard intravenous chemotherapy would permit.
In an Isolated Limb Infusion, a tourniquet is used to stop the blood circulation in the affected limb. A catheter is inserted into both the artery and vein and used to circulate a high dose of the treatment drug into the limb for up to 40 minutes, without the stress on other organs that would normally occur.
When the session is over, the drugs are flushed from the limb, and normal blood flow is returned. The full session can take three hours.
The ILI procedure can safely be repeated if deemed necessary.
ILI Treatment Results
For melanoma, we see response in the tumor in approximately 60% of patients. The technique was developed on the 1990s by an Australian melanoma specialist, John Thompson, MD, as a refinement of an older treatment called Isolated Limb Perfusion (ILP). While the ILI procedure has a good success rate for patients with recurrent melanoma and sarcoma, the skilled team necessary to perform the procedure is rare enough to make it only available at a few centers in the United States.
Clinical Trials for Melanoma
An array of clinical trials for melanoma are available at Fox Chase Cancer Center.
A number of clinical studies are available to patients with various stages of melanoma. Some of these studies evaluate several vaccines for treating patients with melanoma. New drug trials also are available to patients who have widespread disease.
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