UTHSC Department of Surgery Expands Research Efforts; Surgical Oncologist Evan Glazer Brings Ocular Melanoma Clinical Trial to UTHSC

|
Dr. Evan Glazer, left, who joined the Department of Surgery last August, is leading a new clinical trial of a novel treatment for ocular melanoma that has spread to the liver. (Photo by Thurman Hobson/UTHSC)

Evan Glazer, MD, PhD, moved to Memphis last August for more than just the great barbecue.

A surgical oncologist and a physician-scientist, Dr. Glazer was drawn to Memphis, and in particular the University of Tennessee Health Science Center (UTHSC), by what he sees as an opportunity to help develop a multidisciplinary surgical research program at the university.

Most recently at Moffitt Cancer Center in Tampa, Florida, Dr. Glazer was recruited to Memphis by David Shibata, MD, chair of the Department of Surgery at UTHSC, and David Stern, MD, Robert Kaplan Executive Dean of the UTHSC College of Medicine, as the two leaders expand the university’s clinical research enterprise and address major health issues that plague the city, region, state, and beyond.

Dr. Evan Glazer

An assistant professor in the Division of Surgical Oncology in the UTHSC Department of Surgery, Dr. Glazer has a foot in each side of the cancer world — research and clinical. He has particular interest in cancer of the pancreas and liver, and spends half his time doing basic and translational science research on signaling in pancreatic tumors, and the other half of his time in the operating room.

“We’re looking for unique and novel opportunities to help patients in Memphis and the Mid-South with the newest, most-cutting-edge cancer care available,” said Dr. Glazer, who is also affiliated with UTHSC’s research and clinical partners, West Cancer Center and Methodist University Hospital.

“As a member of the West Cancer Center and a surgeon at Methodist University Hospital, advancing clinical care goes hand-in-hand with advancing research,” he said. “It is wonderful for the patients and exciting for the doctors.”

A man on a mission, Dr. Glazer is bringing a new a multicenter phase 3 clinical trial to UTHSC. He is the principal investigator of the Memphis trial of a novel procedure to treat metastatic ocular melanoma to the liver. This rare cancer starts in the eye and often spreads to the liver, carrying less than 10 percent chance of one-year survival. The trial will test the efficacy of percutaneous hepatic perfusion of the liver with Melphalan, a drug that has been effective in treating some other forms of cancer.

While ocular melanoma is rare – less than 3,000 cases annually — Dr. Glazer said UTHSC is the perfect spot for this trial, because it is home to the Hamilton Eye Institute (HEI), which is ranked among the top 10 ophthalmology clinics in the United States.

“With HEI and our ophthalmology program, we see a very disproportionate number of patients with ocular melanoma for the size of Memphis, because lots of patients are referred here,” he said. “It is a great opportunity to combine the strengths of West Cancer Center, Methodist, UTHSC, and HEI.”

A majority of patients with ocular melanoma will develop metastatic disease, primarily or exclusively in the liver. “Those patients typically have numerous lesions of the liver, where resection and other standard liver-directed therapies do not adequately treat this disease,” Dr. Glazer said.

New immuno-based therapies for melanoma of the skin are largely ineffective for ocular melanoma. So UTHSC, along with its clinical partner Methodist University Hospital, are now part of this multicenter clinical trial to evaluate Melphalan administered in a hepatic delivery system.

Funded by Delcath Systems, Inc., a pharmaceutical and medical device company, the trial will compare the standard of care to this novel treatment approach for ocular melanoma that has spread to the liver. Dr. Glazer will perform the procedures at Methodist University Hospital. Patients with chronic liver disease, such as cirrhosis, will not be candidates.

A hepatic delivery system is a device consisting of catheters through which the blood going to the liver is isolated and the blood being removed from the liver is isolated, Dr. Glazer said. “We can treat the liver with high-dose chemotherapy, namely Melphalan, and pull all that chemotherapy laden blood out of the patient, clean it, filter it, and give it back to the patient.” The minimally invasive procedure is done in the operating room, and most patients tolerate the procedure well with only a few days in the hospital.

“Our goal is to treat as much of the cancer as possible and prolong survival,” he said. “I think it can prolong survival, but it has not been proven. Our job is to investigate in a clinical trial.”

The trial is being conducted on 240 patients at 30 centers across the country, and is designed to meet all the FDA criteria for approval should it demonstrate that this is a safe and effective treatment. The UTHSC site is up and running, enrolling patients, and starting treatment next month. UTHSC expects to enroll approximately 10-12 patients over two years.

Dr. Glazer, who received his medical degree from George Washington University, recently completed his fellowship at the Moffitt Cancer Center, where the trial is based. He participated in many similar procedures as a fellow. A team from Moffitt will come to Memphis soon for a brief visit, he said.