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Melanoma: HELP
Articles by Tatiana Beresnev
Based on 3 articles published since 2008
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Between 2008 and 2019, Tatiana Beresnev wrote the following 3 articles about Melanoma.
 
+ Citations + Abstracts
1 Clinical Trial Results of a Randomized Controlled Multicenter Phase III Trial of Percutaneous Hepatic Perfusion Compared with Best Available Care for Patients with Melanoma Liver Metastases. 2016

Hughes, Marybeth S / Zager, Jonathan / Faries, Mark / Alexander, H Richard / Royal, Richard E / Wood, Bradford / Choi, Junsung / McCluskey, Kevin / Whitman, Eric / Agarwala, Sanjiv / Siskin, Gary / Nutting, Charles / Toomey, Mary Ann / Webb, Carole / Beresnev, Tatiana / Pingpank, James F. ·Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA. · H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA. · John Wayne Cancer Institute, Providence St. John's Health Center, Santa Monica, CA, USA. · Marlene and Stewart Greenebaum Cancer Center, University of Maryland, Baltimore, MD, USA. · M.D. Anderson Cancer Center, University of Texas, Houston, TX, USA. · Center for Interventional Oncology, National Institutes of Health, Bethesda, MD, USA. · University of Pittsburgh Schools of the Health Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. · Carol G. Simon Cancer Center, Atlantic Health System, Morristown, NJ, USA. · St. Luke's Cancer Center, Bethlehem, PA, USA. · Albany Medical Neurosciences Institute, Albany, NY, USA. · RIA Endovascular, Greenwood Village, CO, USA. · University of Pittsburgh Schools of the Health Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. pingpankjf@upmc.edu. · Division of Hepatobiliary Surgery, Surgical Oncology Services, Hillman Cancer Center, UPMC, Pittsburgh, PA, USA. pingpankjf@upmc.edu. ·Ann Surg Oncol · Pubmed #26597368.

ABSTRACT: PURPOSE: There is no consensus for the treatment of melanoma metastatic to the liver. Percutaneous hepatic perfusion with melphalan (PHP-Mel) is a method of delivering regional chemotherapy selectively to the liver. In this study, we report the results of a multicenter, randomized controlled trial comparing PHP-Mel with best alternative care (BAC) for patients with ocular or cutaneous melanoma metastatic to the liver. PATIENTS AND METHODS: A total of 93 patients were randomized to PHP-Mel (n = 44) or BAC (n = 49). On the PHP-Mel arm, melphalan was delivered via the hepatic artery, and the hepatic effluent captured and filtered extracorporeally prior to return to the systemic circulation via a venovenous bypass circuit. PHP-Mel was repeatable every 4-8 weeks. The primary endpoint was hepatic progression-free survival (hPFS), and secondary endpoints included overall PFS (oPFS), overall survival (OS), hepatic objective response (hOR), and safety. RESULTS: hPFS was 7.0 months for PHP-Mel and 1.6 months for BAC (p < 0.0001), while oPFS was 5.4 months for PHP-Mel and 1.6 months for BAC (p < 0.0001). Median OS was not significantly different (PHP-Mel 10.6 months vs. BAC 10.0 months), likely due to crossover to PHP-Mel treatment (57.1 %) from the BAC arm, and the hOR was 36.4 % for PHP-Mel and 2.0 % for BAC (p < 0.001). The majority of adverse events were related to bone marrow suppression. Four deaths were attributed to PHP-Mel, three in the primary PHP-Mel group, and one post-crossover to PHP-Mel from BAC. CONCLUSION: This randomized, phase III study demonstrated the efficacy of the PHP-Mel procedure. hPFS, oPFS, and hOR were significantly improved with PHP-Mel. PHP with melphalan should provide a new treatment option for unresectable metastatic melanoma in the liver.

2 Article Isolated hepatic perfusion with high-dose melphalan results in immediate alterations in tumor gene expression in patients with metastatic ocular melanoma. 2010

Varghese, Sheelu / Xu, Hui / Bartlett, David / Hughes, Marybeth / Pingpank, James F / Beresnev, Tatiana / Alexander, H Richard. ·Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA. ·Ann Surg Oncol · Pubmed #20221901.

ABSTRACT: BACKGROUND: Patients with ocular melanoma liver metastases have a poor prognosis, treatment options are limited, and median survival is less than 1 year. In this study, we characterized the early molecular changes that occur in tumors immediately after vascular isolation perfusion with melphalan with hyperthermia in patients with hepatic metastases from ocular melanoma. METHODS: Patients underwent treatment on a clinical trial using a 60-min hyperthermic isolated hepatic perfusion (IHP) with melphalan. Microarray analysis was performed in 28 tumor samples obtained intraoperatively of which 12 were pre- and 16 were post-IHP. Various statistical analyses were performed to identify differentially expressed genes and gene categories between the groups. RESULTS: Median survival of 17 treated patients was 11.9 months. Unsupervised hierarchical clustering of all tumors resulted in separation of pre and post-IHP samples into two distinct groups. Analysis of genes showed that the Ras GTPase activator, ecotropic viral integration site 5 (EVI5), and several other melanoma-associated genes were overexpressed in pre-IHP tumors. In post-IHP samples the overexpression of a DNA replication associated gene, replication factor C (RFC5), was significantly associated with shortened survival (P < 0.003). Other major gene ontology categories identified in the post-IHP tumor samples were DNA-directed RNA polymerase activity and chromatin remodeling, both important categories involved in DNA replication and repair. CONCLUSIONS: These results demonstrate that acute changes in gene expression patterns occur in tumors immediately after treatment with melphalan administered via hyperthermic IHP. Rapid activation of DNA synthesis and repair pathways may be a mechanism of acquired tumor resistance in patients with ocular melanoma.

3 Article Analysis of factors influencing outcome in patients with in-transit malignant melanoma undergoing isolated limb perfusion using modern treatment parameters. 2010

Alexander, H Richard / Fraker, Douglas L / Bartlett, David L / Libutti, Steven K / Steinberg, Seth M / Soriano, Perry / Beresnev, Tatiana. ·Department of Surgery, University of Maryland School of Medicine, 22 South Greene St S4B05A, Baltimore, MD 21201, USA. HRAlexander@smail.umaryland.edu ·J Clin Oncol · Pubmed #19901107.

ABSTRACT: PURPOSE In-transit disease afflicts approximately 10% of patients with extremity melanoma; no single treatment approach has been uniformly accepted as the most effective. We report long-term outcomes in patients with in-transit extremity melanoma who underwent isolated limb perfusion (ILP) in an era of increasingly accurate staging, uniform operative and treatment conditions, and regular long-term follow-up. PATIENTS AND METHODS Between May 1992 and February 2005, 91 patients (median age, 57 years; 50 women, 41 men) underwent a 90-minute hyperthermic ILP (melphalan, 10 to 13 mg/L limb volume, tumor necrosis factor [TNF; n = 44], or interferon [n = 38]) using uniform operative technique and intraoperative leak monitoring. Patients were prospectively followed for response, in-field progression-free survival (PFS), and overall survival (OS). Parameters associated with in-field PFS and OS were analyzed by standard statistical methods. Results There was one operative death (1.1%). There were 62 complete responses (69%) and 23 partial responses (26%) in 90 assessable patients. At a median potential follow-up of 11 years, median in-field PFS was 12.4 months and median OS was 47.4 months; 5 and 10-year actuarial OS probabilities were 43% and 34%, respectively. Female sex and low tumor burden (< or = 20 lesions) were associated with prolonged in-field PFS (male:female hazard ratio [HR], 2.07; 95% CI, 1.27 to 3.38; 21+ v < or = 20 tumors HR, 2.29; 95% CI, 1.21 to 4.34; P < .011 for both). Female sex was associated with improved OS (P = .027; male:female HR, 1.82; 95% CI, 1.07 to 3.09). CONCLUSION In appropriately selected patients, ILP has clinical benefit. The use of TNF was not associated with improved in-field PFS, while female sex was associated with better survival.