Melphalan (Hepzato Kit) to OH Epic Formulary, available via treatment plan, restricted to:

• Indication: Liver-directed treatment for adult patients with uveal melanoma with unresectable hepatic metastases affecting less than 50% of the liver and no extrahepatic disease, or extrahepatic disease limited to the bone, lymph nodes, subcutaneous tissues, or lung that is amenable to resection or radiation
• Service line: Oncology, Interventional Radiology
• Formulary location: Outpatient Infusion
• Service location: Outpatient Infusion, Procedural Area (Interventional Radiology)
• Patient population: Adult (≥ 35 kg)
• Prior authorization required: Yes – Single Case Agreement
• Restriction/criteria of use (all will apply unless specified):
• Confirmed diagnosis of unresectable or metastatic uveal melanoma
• Histologically or cytologically-proven ocular melanoma metastases affecting less than 50% of the parenchyma of the liver, and no or limited extrahepatic disease (disease that is limited to the bone, lymph nodes, subcutaneous tissues, or lung and is amenable to resection or radiation)
• No Child-Pugh Class B or C cirrhosis, or active hepatitis B or C infection
• No New York Heart Association functional classification II, III, or IV active cardiac conditions
• Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
• Will receive no more than six treatments
• Must have failed tebentafusp-tebn (Kimmtrak) or negative for the HLA-A*02:01 mutation

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• Lexicomp
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• Johns Hopkins Guides