Pharmacokinetics and drug resistance of melphalan in regional chemotherapy: ILP versus ILI

James C. Padussis, Samuel N. Steerman, Douglas Tyler, Paul J. Mosca

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations


Two forms of regional chemotherapy for the treatment of advanced melanoma or sarcoma of the extremity are isolated limb perfusion (ILP) and the more recently described isolated limb infusion (ILI). Melphalan is the most commonly employed agent in both ILP and ILI, although it is often used in conjunction with other cytotoxic and/or biologic therapies. While ILP and ILI are far more effective for the treatment of extremity disease than is systemic therapy, there is still significant room for improvement in outcomes, from the standpoint of both response rate and toxicity. An understanding of the pharmacokinetics of regional chemotherapy would allow for the prediction of tumor response and toxicity and therefore patient outcomes. In addition, elucidating the mechanisms of drug resistance would lead to opportunities to develop effective chemo-modulators that enhance the effectiveness of ILP and ILI. This paper reviews progress in these two key areas of active investigation.

Original languageEnglish (US)
Pages (from-to)239-249
Number of pages11
JournalInternational Journal of Hyperthermia
Issue number3
StatePublished - May 2008
Externally publishedYes


  • Chemo-modulator
  • Glutathione
  • Isolated limb infusion
  • Isolated limb perfusion
  • Two-compartment model

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)
  • Cancer Research


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