Trial Information

Selective Intra-arterial Chemotherapy in the Treatment Strategy of Metastatic Spinal Disease

To date, there is no effective systemic therapy for spinal metastases, and the goal of
treatment is to achieve local control of the tumor. Despite advances in radiation therapy,
there is still a subgroup of patients that cannot be effectively treated with radiation
because of close proximity of the tumor to the spinal cord. In addition, in cases of
recurrent tumors, some patients cannot be re-treated because they reached the maximum
allowed radiation dose. Surgery is the alternative treatment for these patients, but some
tumors do recur after surgery while some patients have comorbidities that make surgery a
high-risk procedure.

Based on our prior experience with selective IA chemotherapy for the treatment of ocular
retinoblastoma and the high local control rates achieved with selective IA injection of
chemotherapy in recurrent limb melanoma (limb infusion and limb perfusion) we expect that
spinal intra-arterial chemotherapy with selective injection of Melphalan in the arteries
feeding the metastatic disease is feasible and safe and may prove beneficial in achieving
local control of the spinal tumor, preventing neurological compromise from cord compression.
This minimally invasive approach can be used in patients in whom radiation therapy and
surgery are contra-indicated and essentially have no other treatment options.