Update on posterior uveal melanoma: treatment of the eye and emerging strategies in the prognosis and treatment of metastatic disease

Abstract

Purpose of review: The current treatment options for posterior uveal melanoma and its metastases are reviewed in this paper. Recent developments in understanding genetic and molecular features of these tumors are discussed with emphasis on clinical application.

Recent findings: The management of uveal melanomas has shifted to more eye-sparing approaches without significant improvement in patient survival. There has been an increased understanding of the genetic and molecular abnormalities that lead to melanomas that are more likely to metastasize. Treatments of metastatic disease remain inadequate.

Summary: Uveal melanoma appears to be a systemic disease at presentation. Treatment of the primary disease may be curative in some patients. However, up to 50% of patients will ultimately succumb to the metastatic disease. The accuracy of patient prognostication can be enhanced by tumor cytogenetics. Even with this knowledge, no effective adjuvant treatments exist. Further research and innovation will allow tailored therapies for patients with high-risk tumor features.