Moffitt Completes 100th Percutaneous Hepatic Perfusion Since FDA approval

Leo Silva says he feels like a free person nowadays. 

It’s a feeling that was a long time coming for the 46-year-old from Toronto, Canada. After undergoing different cancer treatments for years, including 150 weekly infusions, he reached a breaking point.  

That’s when he found a new treatment at Moffitt Cancer Center. 

“I’m in a completely different mindset now,” Silva said.  

Silva’s cancer journey began in the summer of 2020 after noticing a wavy line in his eye.  

Doctors diagnosed him with uveal melanoma, a disease affecting the middle layer of the eye. It accounts for 3% to 5% of all melanoma cases and has a high likelihood of metastasizing to the liver, like in Silva’s case.  

Silva says things changed after becoming eligible for percutaneous hepatic perfusion (PHP) with the HEPZATO Kit at Moffitt. HEPZATO uses a hepatic delivery system to inject the chemotherapy drug melphalan into the liver.    

We have dedicated anesthesia team members, interventional radiology faculty and staff and perfusionists that all take part in every single PHP.

Jonathan Zager, MD

100th Procedure 

Moffitt team members recently completed their 100th PHP procedure following U.S. Food and Drug Administration approval, treating patients from all over the world, like Silva who traveled from Canada. 

“We have dedicated anesthesia team members, interventional radiology faculty and staff and perfusionists that all take part in every single PHP,” said Jonathan Zager, MD, a surgical oncologist in Moffitt’s Cutaneous Oncology Department. “The team allows the procedure to be performed safely and has led to successful results.”   

Completed our 100th PHP today post FDA approval . A huge thanks to Delcath, bigger thanks to our incredible team here both in IR and Cutaneous oncology, and lastly, thanks to the patients that trusted us to give them the best care for metastatic UM. @DelcathSystems @MoffittNews pic.twitter.com/6JivKMtPjG

— Jonathan Zager, MD (@jzager99) June 5, 2026

The treatment was approved by the FDA in August 2023 following the FOCUS phase 3 trial results, a multi-institutional trial led by Zager and sponsored by Delcath Systems, Inc.   

Impact on Patients  

Moffitt sees high referral volumes from patients across the U.S. and direct referral international patients. Alongside these referrals, Moffitt’s efforts to train other cancer centers to establish PHP programs have helped expand access to the procedure nationwide. Moffitt team members have trained nearly every U.S. center now offering PHP, with more than two dozen centers currently providing this procedure. 

Zager says it’s best to administer the treatment early. If unsuccessful, patients may move on to other systemic therapies.

“Liver perfusion won't really burn any bridges for any other therapy, but other therapies could potentially burn the bridge for liver perfusion,” Zager said. 

Data shows PHP is more effective than immunotherapy or other liver-directed therapies when used as a first-line treatment. The data also shows PHP can be effective as a second-line option, helping salvage first-line treatment failures. 

Turning Point Reached 

Silva says while he wasn’t initially eligible for the HEPZATO Kit, he was glad he pursued additional immunotherapy to reduce his tumor burden to qualify, pushing through the physical and emotional challenges. 

Leo Silva says he’s looking forward to another family trip. He didn’t feel it was as possible before his PHP procedure.

“But to get to that point and to be able to do the PHP, I think is an incredible thing,” Silva said. 

After a few PHP procedures, Silva says he feels hopeful and has noticed a shift both physically and mentally. 

For the first time in years, he says he’s able to go to the gym and travel comfortably. He credits both his family and members of the Moffitt team for supporting him throughout his journey. 

For now, he has set sights on enjoying a trip to Europe with family. It’s something he says didn’t feel as possible before undergoing PHP. 

“I would say I am much stronger now, more resilient. I'm looking forward to my next PHP treatment to wipe this disease,” he said.