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Review
. 2017 Jan;101(1):38-44.
doi: 10.1136/bjophthalmol-2016-309034. Epub 2016 Aug 29.

Metastatic disease from uveal melanoma: treatment options and future prospects

Richard D Carvajal  1 , Gary K Schwartz  1 , Tongalp Tezel  2 , Brian Marr  3 , Jasmine H Francis  3 , Paul D Nathan  4
Affiliations
Review

Metastatic disease from uveal melanoma: treatment options and future prospects

Richard D Carvajal et al. Br J Ophthalmol. 2017 Jan.

Abstract

Uveal melanoma represents ∼85% of all ocular melanomas and up to 50% of patients develop metastatic disease. Metastases are most frequently localised to the liver and, as few patients are candidates for potentially curative surgery, this is associated with a poor prognosis. There is currently little published evidence for the optimal management and treatment of metastatic uveal melanoma and the lack of effective therapies in this setting has led to the widespread use of systemic treatments for patients with cutaneous melanoma. Uveal and cutaneous melanomas are intrinsically different diseases and so dedicated management strategies and therapies for uveal melanoma are much needed. This review explores the biology of uveal melanoma and how this relates to ongoing trials of targeted therapies in the metastatic disease setting. In addition, we consider the options to optimise patient management and care.

Keywords: Choroid; Ciliary body; Drugs; Iris; Treatment Medical.

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Conflict of interest statement

RDC received non-financial support from AstraZeneca, during the conduct of this work; RDC has received grants, personal fees and non-financial support from AstraZeneca, personal fees from Janssen, personal fees from Thompson Reuters, personal fees from Merck, personal fees from Biogen Idec, personal fees from Aura Biosciences, grants from Melanoma Research Foundation, grants from Melanoma Research Alliance, grants from NIH and grants from ASCO, outside the submitted work. PDN reports personal fees from AstraZeneca, outside the submitted work.

Figures

Figure 1
Figure 1
Representation showing the mutations associated with the RAS/RAF/MEK/ERK pathway observed in melanoma. (Adapted from Vidwans et al102). GPCR, G-protein coupled receptor; RTK, receptor tyrosine kinase.
Figure 2
Figure 2
Summary of key points relevant to multidisciplinary team management of uveal melanoma from the UK Uveal Melanoma National Guidelines.
See this image and copyright information in PMC

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